"New" public management of mentally disordered offenders: Part I. A cautionary tale.

Rarely in public policy is there a consensus on the nature of a social problem. Yet, there is general agreement among policymakers, researchers, clients, and carers that services needed by persons with complex and multiple needs are haphazardly organised and mired in bureaucratic intransigence (Kahn & Kamerman, 1992; Mechanic, 1995; Webb, 1991). The problem, dating back to the 1960s in both the USA and UK, is attributed to the muchsupported policy of community care for persons with chronic and enduring health problems, including mental illness, as well as physical and mental impairments (Mechanic, 1995). Over the years, these governments have been remarkably effective at transferring people from one site (hospital) to another (community), but decidedly less effective in accommodating those who were relocated (Vandiver, 1997). This mismatch has produced a pastiche of unintended consequences: homelessness (Dennis, Buckner, Lipton, & Levine, 1991; Draine & Solomon, 1994; Rossi, 1989; Scott, 1993), criminalisation of the mentally disordered (Abramson, 1972; Fisher, Packer, Simon, & Smith, 2000; Lamb & Weinberger, 1998; Torrey et al., 1992), substance abuse (Kessler et al., 1996; Menezes et al., 1996), social exclusion and isolation (Link, Cullen, Mirotznik, & Struening, 1992), and overburdened family networks (Grad & Sainsbury, 1966; Reinhard & Horwitz, 1996; Tessler & Gamache, 1994; Wolff, Helminiak, & Diamond, 1995). Because the social problem and its unintended consequences are framed in terms of disorganisation, the most favoured solution is services or systems integration (Department of