Primary Care Mental Health Treatment Requirement (MHTR) Practitioner Manual

Matthew Callender, Laura Knight

Research output: Book/ReportGuide or Manual


This guidance manual has been produced to help Primary Care MHTR Practitioners in the delivery of Mental Health Treatment Requirements (MHTR) under a Community Order sentence in England and Wales. It supplements the Clinical Leads Manual, which outlines further information about MHTRs, the intervention and the role of the Clinical Lead.

This document has been reviewed by the CSTR Chairs, Clinical Leads and Primary Care Practitioners. It has been circulated to the national CSTR programme board who has in turn shared it with partner agencies (inc. NHS England and NHS Improvement, and Her Majesty’s Prison and Probation Service) for review and wider comments. Finally, it has also been reviewed by the NHSE/I clinical reference group.

MHTRs sit alongside Drug Rehabilitation Requirement (DRR) and Alcohol Treatment Requirement (ATR) under the umbrella of ‘Community Sentence Treatment Requirements’ (CSTR). They were introduced in their current form in 2003 in England and Wales to enable Judges and Magistrates to tailor sentences according to the nature of the offence and the offender. It is recognised that CSTRs have been used in very few cases, despite evidence of high proportions of convicted offenders presenting with mental health conditions, and drug and alcohol misuse.

The guidance manual provides information about the background, key aims and objectives of the use of the MHTR, the roles of the Primary Care MHTR Practitioner and key partners in the delivery of the MHTR and how MHTRs work in practice in the criminal justice process.
Original languageEnglish
PublisherInstitute of Public Safety, Crime and Justice
Commissioning bodyInstitute for Public Safety Crime and Justice
Number of pages36
Publication statusAccepted/In press - 24 Sep 2020


  • Primary care mental health
  • Mental health
  • Mental health treatment


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