Memorandum submitted by Revolving Doors
Agency
REVOLVING DOORS
AGENCY
For 14 years, Revolving Doors Agency has been
the UK's only charity dedicated to improving the lives of people
with unmet mental health needs who have been arrested or imprisoned.
Our mission is to create opportunities for people caught in the
cycle of crisis, crime and mental illness to transform their lives.
We achieve this mission by combining service development and research,
national public policy work and inclusive service user involvement.
INTRODUCTION
The Justice Reinvestment model is a potentially
powerful means of approaching the challenges faced by the criminal
justice system. It will be important, however, to ensure that
the model is adaptable to the current UK context. In particular,
we need to be clear what UK challenges and policy priorities justice
reinvestment may be a solution to.
Revolving Doors believes that overcrowded prisons,
high offending rates and the overrepresentation of socially excluded
people in prisons are all major policy priorities that justice
reinvestment might help address. However, it is the latter priority
that we think should lead thinking and strategy in this area,
partly because it provides a rationale for deciding for whom prison
might be an inappropriate response (rebalancing criminal and social
justice), partly because it helps to ad-dress the other two priorities
as a matter of course, and partly because this is the group that
the prison system is least equipped to deal with.
The "revolving door"
The "revolving door" refers to the
experiences of people who are caught in a cycle of crisis, crime
and mental illness, whereby they are repeatedly in contact with
the police and often detained in prison. This is a group that
often has multiple problems for which they need the input of a
wide range of agencies, including housing, drugs, mental health,
and benefits. The mental health problems of the group are usually
a core or exacerbating factor. Routinely, they fall through the
gaps of existing mental health service provision, as their mental
health problems are not considered sufficiently "severe"
to warrant care from statutory services; but they are frequently
excluded from mainstream services in the community, such as GPs
and Housing Associations, on account of the perceived complexity
of their needs and their often challenging behaviour.
TWO KEY
POINTS
There are two key points to make about adapting
the concept of Justice Reinvestment to the UK.
1. There is a significant risk of putting all
our eggs in the community services basket.
— It is temptingly straightforward
to assume a shift in investment from prison to community sentences
would solve the problems faced by the criminal justice system.
While a reinvestment of resources into communities would undoubtedly
be welcome, the efficacy of that response may be limited. There
is a risk that it may benefit those people who have the least
amount of need (ie those who are most able to contend with the
demands of a community order) and have a limited effect on the
most vulnerable.
— Furthermore, the most socially excluded
people in prison, many of whom have multiple needs and are on
short term sentences, are among those whom magistrates have least
confidence in giving a community sentence because of the extent
of their support needs, their histories of non-engagement and
the lack of appropriate services in their communities. Unless
their support needs can be addressed (and it is clear that community
services, including Probation, are increasingly struggling), then
a simple shift to community sentences might leave the most vulnerable
individuals in prison.
2. The profile of many prisoners suggests
a strong case for preventing their offending in the first place
rather than attempting to reallocate them within the criminal
justice system.
— Holes in the safety net of community
services are allowing highly vulnerable people to fall straight
through into the criminal justice system. Many people entering
prison have received little of the support that might have prevented
their offence:
| 50% are not registered with a GP.
| 14% have never had a paid job. |
| 42% of men with psychotic disorder have received no help with mental or emotional problems in the previous year.
| 79% of men with personality disorder have received no help with their mental or emotional problems in the previous year.
|
| 33% lack a permanent address or are sleeping rough.
| 68% are not in education, training or employment.
|
| 46% of people arrested who have mental healht problems and are unemployed are not receiving any form of benefit payment.
| 81% of men drinking hazardously in the year before imprisonment received no help with their alcohol problem.
|
These figures show that there is a group of people that is
hard to place and support in existing services. This has been
acknowledged by the Social Exclusion Task Force in Reaching
Out: An Action Plan on Social Exclusion.
"Individual agencies often miss those who have multiple
needs but need less help from any one service ... Their contact
with services is instead frequently driven by problematic behaviour
resulting from their chaotic lives ... and management revolves
around sanctions such as prison."
—Reaching Out, 2006
This is a key insight into the link between the prison population
and the arrangement and delivery of community services to vulnerable
people. Justice Re-investment offers the possibility of driving
reform to those services.
HISTORICAL CONTEXT
20 years ago, many of those currently in prison would have
been warehoused in psychiatric care or large hostels. For very
legitimate reasons, these "catch-all" facilities were
phased out and their residents provided with community "outreach"
support. However, community support has never been sufficient
or flexible enough to meet all of the needs of those people who
were attempting to live independently, or indeed of the new generations
of vulnerable people emerging into the system.
Most obviously, community services have been shaped by risk-led
priorities that have raised the threshold for engagement higher
and higher. This has resulted in many people being left woefully
ill-equipped to cope. While we have rightly rejected institutionalisation
as a blanket response to vulnerability, it has not yet been completely
eliminated, as the increasing capacity of the prison system has
filled the breach.
Six years ago, when the prison population was 25,000 lower
than today, the Government acknowledged in the Social Exclusion
Unit report Reducing re-offending by ex-prisoners that
increasing reliance on imprisonment was drastically affecting
society's most excluded groups.
"There is a growing consensus that we are sending some people
to prison who should not be there. Short prison sentences are
not appropriate for all the offenders who currently receive them,
and too many people with severe mental illness are in prison rather
than secure treatment facilities. All of this contributes to the
problem of overcrowding, which in turn limits the capacity of
prisons, probation and other services to work effectively to reduce
re-offending."
—Reducing re-offending by ex-prisoners, 2002
RDA RECOMMENDATIONS
Revolving Doors recommends that four key issues are considered
so that the Justice Reinvestment model might be used to alleviate
the problem of socially excluded people in the criminal justice
system.
1. Ensure that the money follows the person
— When large psychiatric care units and large hostels
were phased out, the savings were often not reinvested in strengthening
the community-based services where many ex-patients or residents
were turning up.— To avoid history repeating itself,
Revolving Doors Agency believes that the Justice Reinvestment
model must ensure that the money saved in prisons follows the
person to where it is needs in community support services. If
we are using prisons to contain people and manage their behaviour,
then we must ensure that community services are properly equipped
to provide containment and support in order to prevent problematic
behaviour.
2. Invest outside of silos
— A key structural factor that maintains the current
status quo is the silo-based funding powers in each Government
department, which causes each department to understand costs and
savings only in terms of its own purse. This crucially limits
the capacity for lateral creativity between departments.— Rather
than redistributing money within the criminal justice silo, therefore,
the reinvestment model needs to allow greater powers for one department
to invest in another or others, such as the Ministry of Justice
being able to invest in health and social care services.
— Clearly the Ministry of Justice would not have
all of the knowledge needed to understand exactly what would require
investment in another Government department, hence this should
be supported by a collaborative commissioning model that allowed
joint decisions on reinvestment. Locally, this is being modelled
by the new Local Area Agreements, overseen by Local Strategic
Partnerships. This needs to be mirrored at every leave of this
system, as significantly central Government has not imposed this
same discipline on itself.
3. Give better incentives to commissioners
— Currently, there are few direct incentives to
work with individuals with multiple needs. Community services
are measured by simple inputs and outputs, such as entry into
and exit from drug treatment. There is little accountability for
what happens to the whole person, and even less for the prevention
of catastrophic outcomes such as imprisonment. Indeed prison is
a "free good" within communities that provides respite
for services from troublesome individuals.— A mechanism
is needed that aligns the cost of supporting a challenging individual
with the benefit of doing so. In the current system, the cost
of helping someone with multiple needs would be felt by community
services, but the benefit would be experienced by the criminal
justice system (in terms of reduced police, court, prison and
probation costs).
— The Justice Reinvestment model might be understood
and framed in a way that allows the cost of an intervention and
its benefit to be positioned in the same place in the system.
For example, a prison area might hold the resources to reduce
the number of socially excluded people entering its establishments,
and pay health and social care commissioners to provide enhanced
support to individuals who might otherwise not be prioritised
by services. The profile of those individuals could easily be
ascertained through needs audits of people in prison, especially
if their pre-sentence engagement with services was assessed.
4. Service reform
— It is not, however, as simple as shifting money
from the criminal justice system to community commissioners, even
if the most socially excluded individuals at risk of offending
are targeted. The limitations in health and social care systems
are more than financial. The structures of commissioning and delivery
are not well geared towards providing integrated, flexible and
individualised solutions to people with multiple needs.— Justice
Reinvestment, therefore, should be used to drive reforms. In particular,
it should be accompanied by a duty to cooperate from several local
commissioning systems, including the Local Authority, the Primary
Care Trust and the Drugs Intervention Programme. This partnership
should be tasked with creating multi-agency solutions, such as
multi-disciplinary teams, which should incorporate housing, drugs,
criminal justice and mental health workers.
— The Government is currently investing in testing
enhanced methodologies for engaging people it describes as adults
facing chronic exclusion. There is no identified means of sustaining
these methodologies beyond the pilot phase, and the Justice Reinvestment
model might be considered as a way of taking them forward.
— An example of a promising methodology is currently
being tested in Milton Keynes as part of the ACT pathfinders.
Milton Keynes Link Worker +
In partnership with P3 and Milton Keynes Community Safety
Partnership, Revolving Doors is developing the Link Worker+ pilot
as one of the Government's 12 "adults facing chronic exclusion"
pathfinders. Along with the provision of support across all crisis
services, this pilot is pioneering a new form of strategic development
with commissioners. Revolving Doors is facilitating a multi-agency
group, including local criminal justice, health and social care
commissioners. This group has been tasked with affecting wider
system reform based on evidence from the pilot. This group will
respond to the advice of a service user panel and the evaluation
data from pilot in order to make strategic commissioning decisions.
The group has a ring-fenced system improvement budget that will
be allocated in response to this learning in order to help fill
gaps in provisions, creating a learning loop between the operational
and commissioning elements of the project.
Ryan Honeymoon and Julian Corner
April 2008
|
