Primary Care Mental Health Treatment Requirement (MHTR) Practitioner Manual

This guidance manual has been produced to help Primary Care MHTR Practitioners in the delivery of Primary Care Mental Health Treatment Requirements (MHTR) under a Community Order sentence or a Suspended Order. 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 Programme Site Chairs, Clinical Leads and Primary Care MHTR Practitioners. It has been circulated to the National MHTR Oversight Group who have in turn shared it with partner agencies (inc. NHS England and NHS Improvement (NHSE/I), Her Majesty’s Prison and Probation Service (HMPPS), Department for Health and Social Care (DHSC), and the Office for Health Improvement and Disparities (OHID) for review and wider comments.

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 MHTRs 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.