The Government programme of reforms to prisons – 2016

The submission from Steps2Recovery covers the following points:

  • Steps2Recovery – who we are
  • Our approach and context to answering your questions
  • The purpose of prisons and our concerns with current practices
  • Key opportunities and challenges for the central components of prison reform
  • Transforming Rehabilitation
  1. Steps2Recovery – who we are:
    1. Steps2Recovery is a small independent charity with an exclusively abstinence-based recovery focus, working in the field of criminal justice and addiction. For us, abstinence-based means that individuals are expected to remain free from all mind-altering substances, illegal or prescribed. Our initial aim in setting up the charity was to find solutions to the way that individuals repeatedly end up in the prison system due to drug and alcohol addictions, and the subsequent offending behaviour that leads back to prison again and again. As I’m sure the committee know from established research organisations, once caught in the system those with addiction problems are highly likely to regularly return to prison.
    2. Since July 2014 we have run a therapeutic day programme in Hackney for ex-offenders with a history of drug and alcohol abuse. Our clients have often served multiple prison sentences – some on persistent offender (IOM) programmes – and failed previous attempts at treatment for their addiction issues. In partnership with St Mungo’s Broadway we have six beds for clients who would otherwise be homeless, and have space for a further six day clients. Our clients have complex needs – often resulting from childhood trauma – and we provide therapeutic and practical support to help them turn their lives around. We specifically support clients who churn through a revolving door of short prison sentences, with no access to in-prison treatment programmes. We provide an end-to-end service, from gate pick up to move on into safe, abstinence-based housing. We are fully self-funded and take clients based on need rather than their ability to attract statutory funding.
  2.  Approach and context:
    1. We have answered the following questions to the Committee based on our local knowledge of the clients that we see, although recognising that two-thirds of prisoners reported having used drugs in the four weeks before custody and that half of women and nearly a third of men in prison reported needing help with a drug problem on entering prison. The reconviction rates for this group are double those of people who have never used drugs; around 62% reconvict, many within months of release from prison (Bromley Briefings Prison Factfile, Autumn 2015,
    2. The current discharge grant has remained fixed at £46 since 1997. Upon leaving prison many really have nowhere to go, only the clothes they stand up in, and the process of registering for benefits means that any money can take up to six weeks to come through.  If the choice is to return to the crack house that you lived in before prison or sleep on the streets, it is easy to see why this cycle of addiction and conviction is hard to break. And this cycle continues into the next generation – more than double the number of children were affected by the imprisonment of a parent than by divorce in 2009.  Legal Aid has been dramatically cut for those clients involved in child custody cases. The Joseph Rowntree Foundation estimates that the full cost per family over six months averages a further £5,860, on top of the costs of the parent’s incarceration, which includes agencies and childcare.  Not forgetting of course the incalculable costs to society when the impact of crime itself is taken into consideration.
    3. We are reporting to you from our experience with around ninety clients since our inception and the conversations we have with others caught up in the criminal justice system (CJS), recognising this wider context.
  3.  The purpose of prisons
    1. Where possible there should be resources for rehabilitation. It can be a relief to be taken off the streets when a drug problem has become out of control and there is a real potential to set someone on the path to recovery whilst serving a prison sentence.
    2. Our concerns with what seem to us to be the current situation are:
      1. Many of the people we speak to have spoken of the ready availability of drugs in prison and a lack of meaningful activities, meaning that boredom often leads to drug use to pass the time.
      2. Individuals being given access to in-prison rehabilitation programmes such as the RAPt (Rehabilitation of Addicted Prisoners Trust) programme, and then being moved back into a normal prison environment. After completing a tough and worthwhile therapeutic recovery course, individuals may then drift back into casual drug use on a mainstream wing before release from their sentence. This so easily leads back to full scale drug use on release.
      3. The lack of a clear pathway to deal with basic living problems on release means that individuals make suboptimal choices. For example, if a woman expects to be homeless on release she will often chose to stay on methadone or subutex during her sentence – or to be re-toxed onto prescription drugs at the end of her sentence – as her options will be to become street homeless or move into a hostel. Both options involve a high probability of living with others who abuse drugs and alcohol. Staying on a ‘script’ also makes it possible to engage with drug services outside prison which may be another line of hope – although often life once outside prison, homeless and with a drug habit (prescribed or illegal) often means the individual is too chaotic to engage properly with services. And this then so often leads back to prison.
      4. The generational problems with incarceration and drug use. Most of our women clients and many of the women we speak to in prison have children in care. In addition to the real distress this causes to mothers and their children, it is also a significant cost to Local Authorities. Children in care are more likely to end up ‘NEET’, face mental problems or end up in the CJS themselves. The shame and guilt this places on mothers often reinforces the need to self-medicate or self-harm.
      5. The lack of abstinence-based approved premises on release. Many men and women we speak to have been placed in approved premises that are effectively crack houses, leading in many instances down the road back to using drugs, involvement in crime and swift recall back to prison.
  4. Key opportunities and challenges of the central components of prison reform:
    1. Prison reform rightly recognises the dangers drug use does to the prison regime and prisoner safety. However, tightening up security and steps to restrict the flow of drugs into prison, whilst laudable, are not enough on their own. In the past, the introduction of drug testing encouraged the use of heroin rather than cannabis as it passed through the system more quickly; more recently, the use of Spice and other ‘legal’ highs has caused widespread problems in prison, with the accompanying severe health dangers to users caused by manufactured and unregulated drugs. These also bring the threat and use of violence, both between prisoners and to guards, from prisoners under the influence of such drugs. However, sanctions – closed visits, loss of association time, longer sentences and so on – may only deter the few. The above examples show that those with addiction problems will shift their behaviours to allow themselves to continue using. If incarceration was an effective way to deal with addiction problems there would not be the particularly high recidivism rate in this cohort. As the British Medical Association notes ‘individuals who are addicted to illegal drugs have a medical condition which should be treated like any other illness’.
    2. Restricting supply and harsher penalties for possession and use in prison need to be accompanied by adequate programmes to help individuals deal with life without drugs. Our view is that this needs to have a therapeutic input – classroom learning and a certificate is very little support for someone who may have serious underlying trauma, which drives them to self-medicate over and over again.
    3. As soon as possible on admission to prison individuals should be assessed for their willingness and ability to move away from drug and alcohol misuse and offending behaviours and a recovery pathway set in place. This would mesh with Dame Sally Coates recommendation for a rigorous assessment of educational need on reception. Steps2Recovery very much agrees that prisoners should be helped with personal and social development skills, and to raise their aspirations. Even those who are unlikely to enter the job market on release benefit from finding a passion that they can carry forward with life-long learning.

Client story a: A client in his late 50s was released from prison on a lifetime licence to the Steps2Recovery programme in early 2015. An inmate in a working prison with no support from the outside, he had used his wages for living necessities whilst in prison and left with the remainder of earnings of only £5 in his pocket. Although he had been abstinent from all drugs whilst in prison, Steps2Recovery helped him to deal with the transition from a long-term sentence to life in the community and to look at his previous issues with drugs and his subsequent path into the criminal justice system.  S2R gave him the opportunity to consider his options and helped him to find move-on accommodation with an abstinence-based housing charity. He has followed up a passion for art he developed in prison, and now attends college to study art in a more structured setting.

The challenges of austerity run right across the recovery pathway for prisoners with addiction issues:

  • Joining up services to identify and develop effective recovery and rehabilitation pathways will, in the short term, involve additional cost and good problem solving skills – although the longer-term benefit to individuals, society and public funding more than justifies any initial investment.
  • The apparent preference for low-cost educational input on addiction in prisons, rather than any therapeutic input, is a false efficiency.
  • The current short-staffing of prisons means that extra-curricular activities – such as self-help groups brought into the prison by community volunteers – are often cancelled because of a lack of staff to move prisoners around. These meetings can be a critical introduction to support in the community on release.
  • The lack of funding for drug rehabilitation services as prisoners exit the system
  • The lack of probation services resources in the community, to allow them to support their clients in the move from prison to care. This may mean short term (eg- weekend) accommodation in a safe environment, travel passes for rehabilitation services appointments, transitional workers to escort individuals from prison to any move-on facility.
  • The rationale for medicating short-term prisoners with substitute opioids during their sentence is complex, and can lead to risk-averse behaviour on the part of the authorities that does not support the longer-term benefit of the individual.

Quotes from Steps2Recovery clients:

  • “When I was losing my kids and going in and out of gaol drug-workers were saying I needed CBT or therapy but there was no funding and I was never offered any help.”
  • “When I talked to drug workers in prison I kept telling my life story (which was very difficult) and when I came for the next appointment it was a different person and I had to tell my life story all over again. I just wanted someone to see that I’m me, a person.”
  • “Lots of people in gaol want rehab but there’s no funding. There’s no connection between prison and the outside.”
  • “I was an IOM – when I left gaol there should have been red flashing lights. Instead I was just turned out and lived homeless for a year.”

As a part of our response to this Committee we talked to our current cohort of clients about what had been helpful to them.

Client story b: This female client had been helped through a drug detox by the Phoenix Futures staff during her sentence in Holloway. During her sentence she had attended therapeutic groups and had one-to-one support, with a referral to Steps2Recovery on release. On her day of release she was met by a Holloway worker who escorted her to a probation visit to confirm the conditions of her release and licence, and then to the Steps2Recovery house. A victim of domestic violence in the past, she has had her S2R programme extended to ensure she has the best options for move-on housing to support her next steps in life.

Client story c: This male client had undertaken a number of therapeutic programmes in prison, moving onto drug-free wings and, whilst on the RAPt programme, becoming a peer supporter which allowed him to stay on the drug free wing before release. He has had difficulty when leaving prison in the past with becoming self-sufficient and suggests that more can be done to help prisoners towards the end of their sentence by the wider use of Release on Temporary Licence (ROTL), with support around work experience outside of prison and by encouraging those with addiction problems to build a network through attendance at self-help/ 12 step recovery meetings in the community.

Client story d: This client, like many, served only a short sentence which meant that he didn’t have access to any therapeutic intervention whilst in prison, and was given access to lecture-based discussion groups which didn’t provide much help on how to move forwards on leaving prison and dealing with his addiction problems. On release he was homeless and stayed briefly with a family member. His probation officer made contact with a housing charity who, because the client didn’t meet their ‘clean time’ requirement for time since last using drugs, referred him to Steps2Recovery, where he is now two-thirds of the way through our programme, to deal with his addiction problems and with move-on accommodation available at the end of his time with us. 

5.The implications for Transforming Rehabilitation

  1. Good work can be done during an individual’s sentence but this needs to extend to their time as they move out into the community.
  2. The recovery pathway for prisoners with drug and alcohol addictions should extend beyond the prison gates, with an early and clear understanding by the individual of the options available whilst serving their sentence.
  3. We have commented on our concerns about approved premises above. Rehabilitation is unlikely to take place in an atmosphere where drugs and drink are more freely available than in prison. Options need to be made available for individuals taking their early steps into recovery to be placed in safe and ‘clean’ accommodation – where drug and alcohol use is sanctioned, where people are given individual support and advice on the premises, and with encouragement to use community-based groups and services. The alternative, particularly with twelve month supervision orders, is that individuals will be recalled to prison more swiftly and regularly because of chaotic drug use in unsafe premises – which ironically, are ‘approved’ by the very people who should be caring about outcomes for the individuals and society.
  4. We would suggest that the charitable sector has a strong role to play in resettlement, with their clear understanding of the issues around addiction. Our one note of caution is that there is a move to prescribing long-term use of methadone and subutex (buprenorphine). Whilst addicts are of course primarily individuals with individual wants and needs, we would caution against the crowding out of total abstinence-based options by the easier route of prescription drug use. Our personal experience is that there are a significant number of people caught up in the CJS who have a desire to move away from drugs, alcohol and crime but have insufficient encouragement and support within the wider offender management service.
  5. In working with charities, NOMS need to be able to provide some degree of flexibility in their approach. Releasing a prisoner on a Friday, insisting on the individual visiting his probation officer at the local office and then expecting a small charity to accept a new client late on a Friday afternoon is unrealistic and sets a client up for failure. Options might be to agree a release date earlier in the week or, if a Friday release date is unavoidable, for probation officers to manage some degree of flexibility to allow the client to have a proper induction into their new regime.
  6. Individuals should always be escorted from prison to a move-on facility, either by transition workers, probation staff or the charity itself. Despite all good intentions many people get ‘lost’ on leaving prison, seduced by the off-licence that is so often across the road from the prison gate.