Tackling the multiple and complex needs of short sentenced prisoners

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Tackling the multiple and complex needs of short sentenced prisoners

  1. 1. Stopping the revolving door forshort sentenced prisonersBlenheim CDP seminar 22 April 2013Dominic Williamson - chief executiveRevolving Doors Agency
  2. 2. Outline• About Revolving Doors Agency• Policy context• Why focus on short sentenced prisoners?• Multiple and complex needs• What works? Services and systems• Discussion
  3. 3. What Revolving Doors is forOur mission is to change systems and improve services for peoplewith multiple and complex needs who are in contact with thecriminal justice system.We demonstrate and share evidence of effective interventionsand promote reform of public services through partnerships withnational and local political leaders, policy makers, commissionersand other experts and by involving people with direct experienceof the problem in all our work.
  4. 4. What Revolving Doors does:Development &partnershipsPolicy andcommunicationsService userinvolvement
  5. 5. Policy contextCoalition Agreement 2010• “We will introduce a ‘rehabilitation revolution’ that will pay independent providers toreduce reoffending, paid for by the savings this new approach will generate within thecriminal justice system”• Deficit reduction – MoJ 23% cut in this spending round• Cuts to council budgets• Localism• Reform and structural change across health, policing, etc• Focus on integration – Health & wellbeing boards, JSNAs, directors of publichealth, Police & Crime Commissioners (MOPAC in London)• NHS mandate and public health outcomes framework• IOM and liaison and diversion• Community budgets, PbR and Social Impact Bonds• Cost of re-offending – £9.5 – £11 Billion per year
  6. 6. Policy contextDavid Cameron, prime minister, October 2012:– “Today rehabilitation just goes to those who have been inside fora year or more. But that misses all those who go in for shortsentences yet reoffend time and time again. So I want to look atmaking them part of the rehabilitation revolution too.”Chris Grayling, justice secretary, January 2013:– “Offenders often lead chaotic lives: Broken homes, drug andalcohol misuse, generational worklessness, abusiverelationships, childhoods spent in care, mental illness, andeducational failure are all elements so very common in thebackgrounds of so many of our offenders. And right now, we arefailing to turn their lives around. In fact, those released fromshort-term sentences, who have the highest reoffending ratesget no support on release at all.”
  7. 7. Short sentenced prisoners are majority of thoseentering and leaving prison each year6%3%64%19%8%Prison population 31 Dec 2012(excl remand)Short sentenced - lessthan 6 monthsShort sentenced - 6 -12 months4 years or more(excludingindeterminatesentences)48%10%40%1% 1%Prison receptions in year to Oct2012 (excl remand)Short sentenced - lessthan 6 monthsShort sentenced - 6 - 12months4 years or more(excludingindeterminatesentences)SSPs make up 9% of prison population but58% of receptions into prison
  8. 8. Re-offending rates are highest for SSPs0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%All offendersAll finishing prison sentenceDomestic burglaryReoffending by drug misusersShort sentenced prisonersProven one year re-offending rateProven one year re-offending rate
  9. 9. Trends in re-offending by sentencelength
  10. 10. What’s goingon?
  11. 11. In 2011 we reviewed the evidence of the needs of shortsentenced prisoners• Three-pronged approach:– Literature review; Interviews with key stakeholders– Focus group• Large-scale prison surveys:– e.g. Stewart (2008); Niven & Stewart (2005)• Data from resettlement projects:– e.g. Resettlement Pathfinders (Lewis et al, 2003); WestMercia Connect Programme (Leary & Thomas, 2007)• Other research on short-term prisoners:– e.g. Brooker et al, (2009); Maguire et al (2000)• Wider research on the needs of all prisoners.
  12. 12. This concluded that SSPs have multiple needsPrisoners surveyed for the SPCR had an average of threeneeds, while clients of the pathfinders averaged six problems, foursignificant (Stewart, 2008; Lewis et al, 2003).• Practical – housing, debt etc• Family, relationships and social networks• Health and disability• Substance abuse• Underlying emotional problems and poor mental health resultingfrom history of being in care as achild, abuse, neglect, violence, bereavement, isolation and selfharm• Behavioural and attitudinal problems, including angermanagement, hopelessness, institutionalisation, impulsivity.
  13. 13. Structural / environmentCommunityOpportunitiesQuality servicesPublic attitudesMediaMultiple needs: understand the dynamicSelf : MindResilienceCognitive abilityThoughts / emotionPerceptions /beliefsChildhoodContributionInvolvementLearningWorkBasic needsHousingMoneySafetyHealthMentalPhysicalTreatmentSocialFamilyLoveFriendsGroup identity
  14. 14. Multiple needs: negative dynamicStructural / environmentPovertyUnemploymentQuality of servicesDiscriminationStigmaNegative mediaSelf – MindMental / physical painNegative self imagePoor cognitive / socialabilityComplex traumaContributionExclusionUnemploymentCrime - prisonBasic needsRent arrearsEvictionHomelessnessRough sleepingPovertyHealthCommon MHproblemsPoor physical healthNo contact with GPSocialFamily breakdownIsolationNegative peer groupsNo trustedrelationshipOutsider identity
  15. 15. Multiple needs: negative dynamicStructural / environmentPovertyUnemploymentQuality of servicesDiscriminationStigmaNegative mediaSelf – MindMental / physical painNegative self imagePoor cognitive / socialabilityComplex traumaContributionExclusionUnemploymentCrime - prisonBasic needsRent arrearsEvictionHomelessnessRough sleepingPovertyHealthCommon MHproblemsPoor physical healthNo contact with GPSocialFamily breakdownIsolationNegative peer groupsNo trustedrelationshipOutsider identityDrug &alcoholdependency
  16. 16. Interaction between multiple &complex needs and servicesChaotic lives, challengingbehaviour, disengagementMultiple &complex needsPoor serviceresponse
  17. 17. The research literature also confirms what service users tell us:that when they have multiple needs people experience a poorerresponse from services• Complex Responses (2011) identified a number of negativeelements in their experience of frontline services• Driven byMismatch in expectationsPoor quality of staff-client relationshipFragmented Service responseComplexityDelayService exclusion/denialLimitedResourcesInadequate StaffedServicesStrategic PrioritisationInadequate Provision ofServices
  18. 18. What works / what doesn’t?Communitypolice Custody CourtProbationPrisonCJ Liaison &diversionLink worker or similar rolePrimaryhealthcarePsychiatrichospitalIAPTDrug &AlcoholtreatmentBenefits, money &debtadviceSection136Integrated OffenderManagement (IOM)CMHT HousingA & EChaos, crisis, crimeCommunitySentencePlace ofsafety
  19. 19. Where do we find the solution?• Combining evidence from:– Desistance theory and research from criminology– Recovery agenda in mental health– Drug treatment and recovery– Psychology, person centred counselling and psychotherapy– Homelessness – e.g. resettlement– Evaluation of projects and programmes, e.g.• Linkworker schemes• Adults facing chronic exclusion pilots• Elmore project, Oxford etc
  20. 20. Desistance theory – Fergus McNeillAge andMaturationSubjectivities,Narratives, IdentitiesInteractions/RelationshipsLifeTransitions,Social Bonds
  21. 21. So, what does works?• Building a relationship– ‘Someone on your side’ - A trusted relationship within a team– Assertive, persistent outreach and engagement, choice of worker?– Promoting hope, motivation and agency, building on assets and strengths, building self-efficacy– Clinical supervision for caseworkers – support around difficult emotional response /‘projection’– Consideration of case loads – intensity of work• Understanding the individual– Applies a holistic, psychosocial understanding of multiple and complex needs, includingimpact of complex trauma and centrality of relationships / family.– Package of support tailored to individual’s needs, capabilities, gender and culture– Flexible approach, responsive in crisis and relapse– Personal budget / spot purchase of additional support?– Co-produced with service user – ownership of outcomes and plan– Case management with key service providers – planning / troubleshooting
  22. 22. So, what does work?• Service design– Community based but linked to each stage of criminal justice system– Coordination of services, brokering access and creating integrated pathways especiallytreatment and housing– Requires capacity to work with local commissioners and service providers to negotiatenew pathways into services.– Links with communities – goal is integration and connection in community• Service user involvement– Arnstein’s ladder of involvement– Peer involvement in delivery – peer mentors? – drawing on experience of recovery– Peer research and evaluation• Strategic– Supported by strategic stakeholders and commissioners– Gathers data to demonstrate impact, including cost benefits
  23. 23. The building blocks of changeEmergency – Crisis and crime, sleeping rough, arrested, in A&E, leaving prisonOutreach, engagement, immediate access to accommodationStabilizing – supported accommodation, basic needsmet, building trusting relationship, assessment carepathway planning, harm minimisationChange –motivation, treatment, identity, buildingself-efficacy, user involvementConsolidation– preparing forwork, volunteering, trainingInitialdifficultiesProblemsaccumulatingImminentcrisisCommunityResilience throughrelationships
  24. 24. Self efficacy – Albert BanduraSelfefficacyMasteryexperience(Beenthere, done that)Vicariousexperience(modelling)Somatic &emotional states(anxiety /depression etc)
  25. 25. Discussion• Does the concept of multiple needs that I haveoutlined correspond to your experience?• What knowledge and competencies would beneeded in a team delivering this sort of service?• What are the similarities and differences betweenwhat you do now and what would be involved in thiskind of service?
  26. 26. Into the future...• Justice reforms• Justice reinvestment• Troubled families programme• Greater integration – JSNAs, MOPAC etc• Big Lottery Fulfilling Lives programme• Tri-borough community budget
  27. 27. Thank youdominic.williamson@revolving-doors.org.ukwww.revolving-doors.org.ukhttps://twitter.com/RevDoors

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