Jenny Talbot Prison Reform Trust 7 October 2014 Butler Trust Workshop: management and care of people with learning disabilities who offend Jenny Talbot Prison Reform Trust 7 October 2014 1

What I will cover: Film clip: Danny and Graham What is a learning disability and what does it mean? Background/context and prevalence Specific issues; people’s experiences of the criminal justice system Implications for justice, health and social care Research project (if time…): Offenders with intellectual disabilities and social care. Snap shot…

What is a learning disability? The World Health Organisation defines learning disability as a ‘reduced level of intellectual functioning resulting in diminished ability to adapt to the daily demands of a normal social environment.’ An IQ of 50-69 is indicative of ‘mild mental retardation’ or mild learning disability Variations on this definition are followed by the four UK administrations. The reason I show this slide is because there is often misunderstanding about what a LD is. A LD is a lifelong condition and not an illness; it cannot be cured. It is often described as a hidden disability because it’s not always immediately obvious when someone has a LD. The low IQ associated with LD means that it affects everything about the individual – unlike a specific learning difficulty, such as dyslexia, which is unrelated to intelligence. LD and specific learning difficulties, such as dyslexia, that are not identified at an early age can cause significant life problems. 3

Learning disabilities – so what? Limited language ability, comprehension and communication skills: Difficulty understanding certain words Difficulty understanding and responding to questions Difficulty reading body language and following social cues Limited memory capacity: Difficulty recalling information Take longer to process information Difficulty ordering and sequencing Can be acquiescent and suggestible; under pressure, might try to appease others Frequently unable to read and write very well, or at all. LD – so what? Or, for our purposes here today, a defendant with LD, so what? What are the implications for the defendant, for court staff and for members of the judiciary? And, while every defendant will have different strengths, weaknesses and support needs, this slide shows some common characteristics that need to be taken into consideration to help ensure effective participation in court proceedings. Courts are verbally mediated environments, so (from this list) you will appreciate why support for individuals with LD, and other conditions that affect an individuals communication and/or comprehension, is so important.

Background/context: Closure of long stay institutions Home Office circular 66/90 Reed Report, 1992 Disability Discrimination Act 1995/2005 No One Knows, 2006 – 2009 (PRT) Anne Owers ‘Kafka-esque’, 2008 UK Joint Committee on Human Rights 2008 Bradley Report, 2009 (review from 2007) Autism Act 2009 Equality Act 2010 CJJI of the treatment of offenders with LD within the CJS – phase 1, 2014 Care Act 2014. Closure of long stay institutions; more people with learning disabilities living in the community 66/90 Provision for mentally disordered offenders Reed Report: ‘Review of health and social services for mentally disordered offenders and others requiring similar services’; recommended nationwide provision of properly resourced court assessment and diversion schemes; report by NACRO in 2004 found that only around a third of courts had access to such schemes and that very few employed any LD expertise. DDA – particular focus on the inclusion in society of people with disabilities and ensuring that discrimination does not occur by making reasonable adjustments; further reinforced in 2005 amendments and the Equality Act 2010 NOK A 2008 report by HM Chief Inspectors of prisons and probation, ‘The indeterminate sentence for public protection’ described the predicament of prisoners with low IQs being required, but unable to complete OBPs to secure their release as ‘Kafka-esque’ UK Joint Cttee on HR published a report, ‘A life like any other? HR of people with LD’, which included a section on criminal justice – more later Bradley Report, Lord Bradley's Review of people with MHP or LD in the CJS – more later; in bold because particularly significant in ensuring and keeping this group on the agenda Autism Act – Caroline Bang up to date, part one of a CJJI, from arrest to sentence; part 2 being due out later this year and will be reporting on probation and prison.

UK Joint Committee on Human Rights: Expressed concerns about: “…the rights of people with learning disabilities to a fair hearing, as protected by common law and by Article 6 ECHR” “…serious failings in the criminal justice system that gives rise to the discriminatory treatment of people with learning disabilities” “We are deeply concerned that… because of a failure to provide for their needs, people with learning disabilities may serve longer custodial sentences than others convicted of comparable crimes” (March 2008). 2008

The Bradley Report: Review of people with mental health problems or learning disabilities in the criminal justice system; 82 recommendations “The first step to the effective management of offenders [with mental health problems or learning disabilities] is the existence of good early identification and assessment of problems, which can inform how and where they are most appropriately treated.” Recommendation that all police custody suites and criminal courts have access to liaison and diversion services (Department of Health, 2009) NHS England, by 2017. 2009

Criminal Justice Joint Inspection: Police: “Many detainees learning disabilities were not adequately assessed or recorded Appropriate adults were not always called even when it was recorded that the detainee had a LD Referrals were not always made to relevant adult care services, leaving adults with LD vulnerable when released from custody.” Courts: “For someone with a learning disability, the court environment and process is confusing and possibly frightening Specialist training… to ensure defendants with learning disability are supported appropriately at court, was needed.” CJJI on the treatment of offenders with LD within the CJS - phase 1, ‘from arrest to sentence’, January 2014 (six years after report from the UK Joint Committee on HR) Phase 2, on probation and prisons, imminent

Criminal Justice Joint Inspection: Probation/PSR writers: “The majority of reports and assessments were timely and provided useful information to the court Reports and assessments failed to take account of the likely impact of the offender’s learning disability on their ability to engage with their order Offender managers gave too much weight to the offender’s needs at the expense of possible risk of harm factors.” (CJJI on the treatment of offenders with LD within the CJS - phase 1, 2014). Conclusion: A balance needs to be struck between the support needs of those with learning disabilities and the need to hold them to account, where appropriate, for their offending. At all points in the criminal justice process, up to and including the point of sentence the treatment of people with learning difficulties could be significantly improved. Without the ability to correctly identify and assess the detainee’s learning disability, at the arrest and charge stages, there is a greatly reduced chance of them receiving the support they need or the access to services to help them understand what is happening as they go through the system and the consequences/implications of decisions made. Even when an offender’s learning disability is correctly assessed, at arrest, that information is not always recorded or communicated to the Crown Prosecution Service who need that information to inform their charging and decisions on how to proceed with the case. The lack of information sharing can then affect the ability of probation staff preparing reports for court, to correctly assess both the offender’s needs, and leading to an incorrect assessment of the most suitable court order to reduce the likelihood of reoffending. Following conviction, probation staff, preparing reports to court, often fail to either recognise or understand the nature and affect the offender’s learning disability may have had, on their offending. This failure can mean that they do not provide the court with all the relevant information they need to sentence the offender and can impact on the quality of any supervision post-sentence.

Prevalence: 25% of children who offend have an IQ <70 (Bailey et al, 2005) 60% of children who offend have communication difficulties (Bryan et al, 2007) 20 – 30% of offenders have learning disabilities or difficulties that interfere with their ability to cope within the criminal justice system (Loucks, 2007) 7% of prisoners have an IQ <70; a further 25% have an IQ <80 (Mottram, 2007) Between 5 – 10% of adult offenders have a learning disability (slightly more than 2% of the general adult population has a learning disability). 60% of children who offend have communication difficulties and, of this group, around half have poor or very poor communication skills (Bryan et al, 2007)

Specific issues, generally: Reading: four-fifths of prisoners with learning disabilities had problems reading prison information Writing: three-quarters had problems with writing and filling in forms Understanding: screening tool results showed that around two-thirds had problems with verbal comprehension Being understood: two-thirds said they had problems making themselves understood (Talbot, 2008). Provide background to the research, i.e. prisoners similar experiences in police custody and courts

Experiences at the police station: I didn't know I was charged, they didn’t read me my rights. I didn’t know what was happening. The way they looked at you was scary. When you go up to the counter in the custody suite lots of people watched and they read out your charge. People look at you and then you are allowed to leave. There was a solicitor, one police lady and two other people. I don’t know why they were there, police talk maybe. It was somebody I didn’t know before I got in trouble with the police. I didn’t know if it was somebody who could have helped me. AAs; fewer than a third said they had support

Experiences in court: I couldn’t really hear. I couldn’t understand but I said, “yes, whatever” to anything because if I say, “I don’t know” they look at me as if I’m thick. Sometimes they tell you two things at once. I sat behind the glass and there were three ladies sitting there. I didn’t know what ‘remanded’ meant. I thought it meant I could come back later. I am not good at speaking and they don’t listen. I needed more time to explain myself. I understand that I have done something wrong, but I’m still not quite sure as to what that is. Reasonable adjustments etc

Specific issues, in prison: Prisoners with LDD were five times as likely to have been subject to control and restraint techniques than prisoners without such conditions And they were three times as likely to have spent time in segregation They were almost three times as likely to have clinically significant depression or clinically significant anxiety than prisoners without such conditions, and many experienced both.

Experiences in prison: When I first came in I was petrified. The first one and a half years were really bad. I tried to commit suicide three times. You get a meal sheet but it comes through the door. You have to hand it in before you get out of your cell and loads of the meals I get aren’t what I want. Everything is one big problem. I am a bit scared in the shower. Someone got raped in the shower by eight lads and then two days later he killed himself and that scared me. So now I feel nervous in the shower. I don’t know how to use the phone; it’s that PIN thing isn’t it?

Implications: Adhere to the principles of equality and inclusion Joint working and shared learning: justice, health and social care (equality awareness and specific training ) Information sharing Screening – knowing who needs support at the earliest possible stage Ask those directly involved – experts by experience ‘Pathways’: staff knowing what they should do; multi-agency liaison; specialist referrals, where necessary; timely provision; a different way of doing things? Leadership. Check lists for action Who to look to? Sharing good practice… Leadership – forgive me, Lisette Saunders…

Offenders with ID & social care (OFFSCA-ID): Study led by professor Glynis Murphy (University of Kent and Canterbury and NHS National Institute for Health Research) on the costs and benefits of social care support for ex-offenders with LD. Key questions: Does social care input affect the mood, behaviour and quality of life of ex-offenders with LD? What are the costs of social care for these offenders? How does the social care input alter outcomes in terms of re-offending? ‘ex-offenders with LD’ – meaning, upon their release from prison and after a period of 9 months living in the community Main concerns from people with a LD who helped scope this study, including members of the Working for Justice Group, were: A need for support upon leaving prison, ‘being left at the gate’ Difficulties adjusting to life outside of prison, especially: Handling money and money concerns; no longer having the luxury of a bed, three meals a day and a routine Peer pressure; keeping yourself safe; making ‘good’ friends Feeling misunderstood.

jenny.talbot@prisonreformtrust.org.uk www.prisonreformtrust.org.uk Thank you jenny.talbot@prisonreformtrust.org.uk www.prisonreformtrust.org.uk