My Journey To Becoming A Crown Court Clinical Nurse Specialist

“It is an extremely rewarding sector with a wide range of opportunities... I would recommend that any Mental Health Nurse enters the exciting area of forensic healthcare for the next step in their career.”

If you’re searching for a unique and rewarding career in mental health nursing, then becoming a Crown Court Clinical Nurse Specialist could be for you. This role is part of the Forensic Healthcare Service and requires diverse knowledge of mental health and the legal system. Chris takes us through his journey to becoming a Crown Court Clinical Nurse Specialist, as well as what the job entails on a day-to-day basis.

My Journey Into Nursing

Like many others, my route towards nurse registration didn't follow a clear path. When I first went to university, I completed an Undergraduate Degree in Journalism and a Master’s Degree in Law. I then went on to pursue a career in the legal sector, working at a law firm with a view towards training as a solicitor.

However, at that time of my life I did not feel comfortable in the corporate environment, and I decided to change career track. I went to work in a rehabilitation unit for homeless individuals experiencing substance misuse issues, and it was here that I first developed my understanding of how to support others experiencing complex needs.

Although I found working in this field challenging, it was also extremely rewarding and over the next eight years I went on to work for the substance misuse service in magistrate’s courts, police custody centres, and a prison.

My experience in these environments was invaluable as I got to see first-hand the impact of social inequality and how this can shape an individual's life trajectory. I became more conscious of the fact that someone's personal circumstances, especially those in the early years, can have a significant impact upon their risk of having contact with the criminal justice system as an adult.

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Completing My Degree In Mental Health Nursing

After several years of working within the prison I became more interested in further study, and I decided that for my professional development I would train as a nurse. I completed an Undergraduate Degree in Mental Health Nursing and qualified in 2016. I have also recently completed a Master’s Degree in Clinical Research part-time alongside my employment.

Upon leaving university I went on to work in psychosis services for approximately five years. Although I retained an interest in working within the forensic environment, I hadn’t yet identified the type of role that I felt would best suit my skills and experience.

Working In The Forensic Healthcare Service

However, I then became aware of a new mental health service being planned for the Crown Courts that was to be provided by the Liaison and Diversion Service. The Liaison and Diversion Service comes under the wider Forensic Healthcare Service, and they deliver clinical assessment and risk assessment of detained individuals experiencing mental health issues within police custodies and Courts.

I successfully applied for the position, and I have now been employed as a Crown Court Clinical Nurse Specialist for almost two years. I am based full-time within the Crown Courts, and I am the only specialist practitioner within our area carrying out this role. After setting up the pathway with the support of the Service Manager, demand for the service has remained high.

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What Does A Crown Clinical Nurse Specialist Do?

My day-to-day work is diverse, and I have found that each week presents me with a new challenge that tests my analytical and assessment skills. In summary, I provide mental health expertise to the Crown Court Judiciary and support decision-making and the appropriate diversion of offenders with mental disorders and other serious vulnerabilities from the Criminal Justice System.

This is undertaken through detailed information gathering and assimilation, alongside a clinical risk assessment and a mental health assessment of defendants. I am required to feedback this information within written detailed reports and verbally within the Courtroom on a regular basis.

Throughout the week I meet with defendants with active criminal proceedings in the Crown Court. I will usually be given several weeks to arrange the assessment and write up a report, although I am sometimes required to assess and verbally feedback my findings within a Court hearing inside of an hour.

My objective is to identify whether there are any issues relating towards their mental health, assess their capacity to engage in Court proceedings, and/or any potential issues around culpability. I may recommend to the Court that a further assessment is undertaken, and if so, I will arrange this with a Consultant Forensic Psychiatrist on behalf of the Court. I will also undertake the assessment of defendants around their suitability for community disposals, such as a Mental Health Treatment Requirement, or make recommendations around alternative options.

My day-to-day work is diverse, and I have found that each week presents me with a new challenge that tests my analytical and assessment skills.

What Knowledge Is Essential For The Role?

To undertake my role I need to have knowledge of the Mental Health Act 1983 (amended 2007), in particular Part III of the Act which relates towards patients concerned with criminal proceedings.

Furthermore, an understanding of the Criminal Procedures and Insanity Legislation governing unfitness to plead, insanity, and alternative disposals is essential, and I will need to be available to support the Judiciary and defence counsel in navigating this area when required.

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Liaising With The Crown Court & Healthcare Services

A significant proportion of my work is also acting as the liaison between the Crown Courts and healthcare services, and working to ensure that clinical information gathered elsewhere, for example hospitals and community healthcare teams is provided to the Courts effectively.

To meet this need I have had to establish effective pathways for communication and data-sharing with the different agencies involved in with the Crown Court (e.g., the Crown Prosecution Service, The Probation Service, Police, Prison Services), whilst giving consideration to my obligations under the Data Protection Act 2018.

Keep Up With Current Mental Health Treatments

To provide an efficient service to the Court, it is important for me to have a comprehensive and up-to-date knowledge of available mental health treatment pathways, as well as the entry criteria and routes into healthcare services to ensure timely referral for those who are in need of primary, secondary, or acute mental health treatment.

I have found that this is a common area I will be questioned upon in the Courtroom by the Judiciary, CPS, and defence teams, and therefore I regularly liaise with other healthcare services to ensure that my knowledge is up to date.

Have Confidence In Your Legal Knowledge & Professionalism

I need to be able to operate proficiently within the legal environment, which is often very demanding and complex. The Crown Court hears the most serious criminal cases, and I can be called upon to assist with defendants who have allegedly committed a wide range of offences, for example robbery, violence, child sexual offences and murder.

I regularly meet with senior members of the Judiciary and other agents of the Court, and I must therefore maintain high levels of professionalism in my conduct and communication. Presenting information within the Courtroom can at times be challenging, especially if it is in relation to a particularly difficult case.

An example of this may be where I am asked to advise the Courtroom of the symptoms associated with a particular diagnosis, and what the defendant's experience of these symptoms are. This may take place in front of a full Courtroom.

It is an extremely rewarding sector with a wide range of opportunities... I would recommend that any Mental Health Nurse enters the exciting area of forensic healthcare for the next step in their career.

Working Autonomously While Looking After Wellbeing

These responsibilities require me to work autonomously in line with the seniority of my grade, and therefore I need to be confident in my decision making and ensure that I am resilient in my approach.

Nevertheless, I engage in regular clinical and management supervision to ensure that I am able to continue to deliver effective decision making and to maintain my own wellbeing.

What Do I Do Outside Of My Role?

Outside of my role within the Crown Court, I am also on the management team for the wider Liaison and Diversion Service who are based within the police custody suites and magistrate’s courts.

I work with the leadership team to ensure that activity within these areas meets the appropriate clinical standards and ensure that any issues relating towards partnership working and staffing are managed. I also contribute towards internal and external steering groups as required.

Forensic Healthcare Can Be A Rewarding Sector

What has become clear to me since being in this role is that many of the other professionals within the Criminal Justice System have similar objectives to myself - to ensure that all defendants receive equal treatment within their criminal proceedings before the Court.

Not only will this ensure that everyone is treated justly, but it will also contribute towards protecting the public, reducing reoffending, and reducing the health inequalities for some of the most vulnerable within society.

Like other areas of mental health services, working in forensic healthcare can occasionally have its challenges and there have been times that I have felt the pressure.

However, it is an extremely rewarding sector with a wide range of opportunities, for example within acute, community or liaison services. I would fully recommend that any Mental Health Nurse enters the exciting area of forensic healthcare if they are considering the next step in their career.