Mental health and sentencing: How are judicial decisions made in light of the judgement of R v Vowles? (A partial replication of )

In England and Wales, s.45 A of the Mental Health Act 1983 allows a judge to pass a sentence including both an immediate direction to hospital as well as a punitive custodial element. R v Vowles provides four specific considerations for judges to attend to when considering such sentences (referred to as the 'Vowles statements'). In a previous study (Baldwin et al., 2025), we examined how a proxy judicial sample made decisions about sentencing in line with this case-law. Whilst s.45 A was, in contrast to real world outcomes, very popular, not all of the Vowles statements were predictive of the final sentence. Moreover, differences in the diagnostic description presented to judges resulted in little difference to sentencing outcomes. However, this study suffered with a number of methodological limitations which the present study aimed to address. Our findings largely mirrored those of our original study; s45A remained a popular option with judges, and of the four Vowles statements, the studies together clearly indicate that a belief that the defendant requires punishment is by far the most important factor. Combining the samples of the two studies indicated a small effect of diagnosis on sentencing behaviour, and there was significant evidence of variability between judges in their appraisals of the Vowles statements. This study illuminates the need for better understanding of judicial decision-making processes concerning defendants with mental health concerns.