1. Turnaround Service September 2009

2. What we intend to cover? Background on Turning Point Scotland The context of the national drugs strategy in Scotland? Background to the Turnaround service Key aspects of services provided Challenges and issues going forward

3. What about Turning Point Scotland Roots lie in working with people with addictions Driven by social, cultural and value based principles Significant development over past 10 years Strong focus and experience in service delivery Good coverage across Scotland Positive reputation and profile

4. TPS has 36 services Throughout Scotland. Of these, 12 are classified as substance misuse services.

5. Demographics & incidence Estimated that 52,000 people in Scotland are problem drug users – almost 1 in 50 of our population aged between 15 and 54. This number does not include recreational drug use such as cannabis, cocaine and ecstasy – which are the three most commonly used illegal drugs.

6. Demographics & incidence In 2007/08, the public sector spent £173 million on drug and alcohol services in Scotland, £84 million specifically on drug services and £30 million on alcohol services. Remainder spent on joint drug and alcohol services

7. The Scottish Drugs Strategy – The Road to Recovery Preventing drug use. Promoting recovery. Law enforcement. Getting it right for children in substance misusing families. Making it work.

8. The Road to Recovery Need to move on from the abstinence v. harm reduction debate Promoting the concept of recovery Need to better organise and co-ordinate services across Scotland

9. Background of Service Suicides in Corntonvale Prison (8 suicides over a 18 month period) Safer Way Report 1998 (highlighted women who serve short term sentences could be dealt with better in the community) Better Way Report 2002 (not a lot of changes made in relation to community orders and 218 established) – both reports indicated that a high proportion of women going into custody had substance misuse and mental health issues) Highlighted that women could be dealt with more effectively in the community – in particular for short term sentences 218 service was established for women as a direct alternative to custody (direct alternative to custody through residential and day service offers enhanced support to criminal justice orders Number of women from Glasgow placed in custody in Corntonvale has reduced

10. Male Offending Recognition by TPS that a service for male offenders should be developed with success of 218 TPS raised substantial funds through a range of discretionary funders and approached Scottish Executive to match funding Joint service with APEX/VENTURE TRUST and TPS agreed with Scottish Government (apex – venture trust and TPS are working jointly to ensure a pathway for service users from chaos to stability. Venture trust (outdoor experience) APEX (employability) TPS (all issues in relation to offending behaviour) Longer term approach to offending behaviour Mapping exercise carried out to identify areas for service to be placed (Offending, Scottish Index of Multiple Deprivation)

11. What areas do we cover? Day services open to those who are within base area Residential unit open to 10 local authorities covered by NS and SW CJA

12. Day Services 4 day bases situated in NCJA and SWCJA area – Inverclyde, West Dumbarton, Irvine and Kilmarnock Every area may be supported in different ways in relation to where the service fits in e.g. Ayrshire Probation, West Dumbarton Constructs work Male 18-30 Persistent offenders – live connection with criminal justice system, warrants, bail, Deferred Sentence, DTTO, breach of orders, non engagement with orders, short term prison sentences, revolving door history, additional intensive support required Trying something different – what's not worked with this group of men Intensive support programme to work with Courts, Criminal Justice Area Teams and other services to provide an enhanced support service to male offenders

13. Residential Appropriate for the most chaotic, vulnerable offenders who cannot engage with services in the community 10 bedded residential unit Open to all local authorities Can be used as an alternative to custody Criminal justice order e.g.. Possible breach

14. Structure of Unit Full comprehensive assessment – drug use, offending, accommodation, benefits, mental, emotional and physical health, service support Fully structure programme One to one work daily Group work daily Weekly review of progress Maximum 6 week stay

15. Structure of Residential Programme Content: Daily group work focusing on issues relating to offending behaviour. Groups include Change, Anger management, Triggers, Victim awareness, Relapse prevention. Daily one to ones take place to cover all the above issues in depth and work through issues specific to individuals. Intensive work is complimented with alternative therapies such as acupuncture and various educational and recreational activities. Medical team on board to work with individuals on health and substitute prescribing needs. Partnership work with Apex and Venture Trust.

16. Referral process Telephone referral taken Assessment can be completed by e-mail/fax Clear exit plan needed to ensure consistency in care when returned to the community of source Clear plan needed in relation to prescribed medication Clear plan in relation to support from referrer whilst in residential unit Clear plan in relation to early demission or service user leaving unit

17. Expectations from CJ Sign up for clear exit strategy Sign up for contact whilst in residential Attend at least one review (minimum) – mid way review Ensure communication channels are clear from both sides with clear roles and responsibilities in relation to the care plan Clear plan in relation to any visits or court dates (flexibility is needed)

18. While deprivation and problem drug use are all associated with poorer health, increase in crime, they are also associated with poorer service use...... the challenge for service providers is to provide care which is appropriate to need and which they will want to use.

19. Challenges Challenges that clients face include: Issues with housing on return to the community Outstanding legal matters whilst staying in residential Returning to community- existing peer group, family support, building positive networks, maintaining daily structure. Stigma Barriers to accessing services such as healthcare services perhaps due to lack of engagement in the past Barriers to employment

20. Recovery focused practice – What next? We need funding targeted at providing support at each step of an individual’s ‘road to recovery’, not just at primary care. We need to provide continued supports for people when they are stabilised or stopped their drug use. People need continued support as they move on in their journey into education, training or employment, to develop or re-build personal and social relationships.