How do Criminal Defence Barristers Work with Psychological Distress throughout the Courtroom Process?

Whilst a significant proportion of those coming through the Magistrates’ Court have mental health difficulties and associated social disadvantage and vulnerability, there would appear to insufficient resources to meet their needs. Eight criminal defence barristers, who received no professional training in mental health, were interviewed about their experience of working with these clients. Thematic analysis of data, from a critical realist epistemological position, generated two themes. “Working with clients’ mental health difficulties” describes how mental health is constructed, identified, and defended; the systemic issues that may compromise the defence; barristers’ attempts to mitigate harm and manage distress; and finally, barristers’ own distress. “Professional anxiety” captures how barristers are strained by their recognition of a flawed system; conflicting obligations to the court and their client; and pressures of poor resources, feeling very responsible, and needing to present an illusion of confidence.
A discussion of these results included consideration of the potential for a medicalising narrative to lead to legal paternalism (subjugating the client’s autonomy in an attempt to act in their “best interests”); and the deprivation of defence options; possibly representing unintended human rights violations. Barristers found clients with mental health needs were particularly emotionally taxing, desired training to work with them, and suggested that these clients were vulnerable to wider discrimination and inequalities in the criminal justice system. Concerns were raised by the barristers’ significant risk factors for “burnout” (a state of psychological stress), and the implications of this for both their emotional well-being, and the risk of exposing their clients to financially driven unethical behaviour. Systemic changes, informed by clinical psychology, were recommended, including training for barristers