Widening the Net: Assertive Outreach and Criminal Justice Graham Durcan and Rob Fitzpatrick

How can offenders with complex needs get a better deal from mainstream services?

The offending population Type of problem Prevalence among prisoners Prevalence in general population Psychosis 8% 0.5% Personality Disorder 66% 5.3% Neurotic Disorder 45% 13.8% Drug Dependency 5.2% Alcohol Dependency 30% 11.5% (Singleton et al. 1998) (Singleton et al. 2001)

Social exclusion Most unemployed before and after prison Around half have housing problems pre and post prison RDA study: 49% people with MH problems had no permanent residence on release Learning disability borderline disability, learning difficulty all highly prevalent. Half have no doctor on release Debt problems widespread Most reconvicted

Sub-threshold mental illness and complex needs Multiple problems/needs/vulnerabilities is the default In a Sainsbury Centre study most prisoners had experienced multiple trauma in childhood /adolescent years Prison adds to difficulties – health and social Multiple problems - but often individual problems are sub-threshold Sainsbury Centre prison caseload profiling

Adults facing chronic exclusion Multiple need: mental illness; personality disorder; alcohol dependence; drug dependence; learning disability; adult neuro-developmental disorders Chaotic lives: difficulty dealing with paperwork; difficulty managing money; no formal qualifications; no confidant; few friends; unemployed; highly mobile; low income (Schneider et al 2007)

Why divert? 92,500 prisoners in the UK (Eng’ /Wales=83,000 ) 100,000 plus predicted for 2014 Huge rate of ‘churn’ & inter-prison transfers Prison building programme-negative investment Mental Health Act and prisons Diversion – variability and poor coverage Justice reinvestment Multi-modal approaches (wrap around: MST& RAP)

Criminal Justice Diversion (1) The full model is available from www.scmh.org.uk/criminal_justice/diversion.aspx

Criminal Justice Diversion (2) The Bradley Review Early intervention Courts Prison, community sentences, resettlement Partnerships

New Horizons NSF 10 year plan that’s almost 10 years New Horizons Young people complex need Offenders Complex need Early intervention Assertive working

Question 1 Your experience of working with offenders? Barriers to accessing mainstream services? Working with criminal justice and social care agencies?

Question 2 In a time of recession - A job for whom?

Question 3 What kind of clinical & non clinical interventions should be available to offenders with complex needs? - how should these be organised?

Question 4 What interagency partnerships are required to improve the access of offenders to appropriate services? How should we commission?

Question 5 How can offenders be more effectively involved in the planning and delivery of services?