When delivering recovery services to prisoners, demonstrating impact is a complex but vital process, says Carwyn Gravell.
Forward’s range of structured, abstinence-based treatment programmes (which we refer to as the ‘RAPt’ programmes) have supported thousands of people into lasting recovery. Our range and type of programmes have grown and diversified since we first began helping people from a portacabin in HMP Downview in the early ’90s. So too have the tools we use to measure their impact. Our recently launched annual Impact report includes a summary of the research on the impact of these programmes.
The first published study into the RAPt programmes was Drug treatment in prison: an evaluation of the RAPt treatment programme by Player and Martin of Kings College London in 2000. This gave the first evidence of our successful impact in reducing reoffending – a one-year rate of 25 per cent amongst the 274 completers of our programme, compared with 38 per cent for non-graduates. A second study, Effectiveness of the rehabilitation for addicted prisoners trust (RAPt) programme, published in 2014 and using data from the Police National Computer (PNC) database, showed a 31 per cent reconviction rate for graduates of our programmes in male prisons, an 18 per cent drop in reconviction rates and a 65 per cent reduction in the volume of re-offending.
The establishment of the Justice Data Lab (JDL) in 2013 has provided us with a national framework to evaluate the success of all our interventions in reducing reoffending. We have so far submitted two cohorts of data for analysis by the JDL, with our most recent results being published in October of this year. A JDL study into our Women’s Substance Dependence Treatment Programme (WSDTP) showed that women who completed the programmes reported a one-year re-offending rate of just 18 per cent, while a similar study into our less intensive Alcohol Treatment Programme reported a reoffending rate of 37 per cent.
Just how positive is this impact? There are methodological limitations in estimating the likely reoffending rate for a comparison group of drug or alcohol dependent offenders who do not access these programmes. For example, the Justice Data Lab comparison groups (with re-offending rates of between 35 and 40 per cent) are based on a criteria of frequent drug/alcohol use, rather than dependence, leading to significant underestimates. Other estimates of the reoffending rates of drug/alcohol dependent offenders range between 58 per cent (participants of all accredited drug/alcohol programmes in prison, according to an MoJ Analytical Series study from 2013) and 76 per cent for ex-prisoners who reported using class A drugs post-release (in the same study). Taking this upper-end estimate as a comparison, RAPt programmes could potentially reduce reoffending by nearly 60 per cent.
Yet despite this significant impact, we have seen a decline both in the number of people starting programmes (a reduction of 58 per cent over the last three years) and in programme quality. The increasingly challenging prison environment (an aggressive prison drug market, lack of space on dedicated ‘recovery wings’ to run group programmes, prison ‘lock-downs’ preventing programme delivery, and placing of inappropriate referrals onto programmes) is part of the reason. That being said, we have also realised, through consultation with staff and service users, that we need to improve the way we prepare applicants for the intensity of our programmes.
The development of our Stepping Stones courses (a shorter intervention that gives people a taster of the kinds of things covered in more intensive treatment) has helped. For example, at HMP Send –where we run WSDTP – the introduction of this stepped model has led to a 25 per cent increase in programme completion.
The process of quantifying the impact of our work is not always straightforward. Maintaining programme integrity in a hostile prison environment – and designing accurate research methodologies – remains a challenge. But it is worth it. Because proving that our work can – and has – helped thousands of people to turn their lives around is essential to building a reliable evidence base for this sector.
The progress of women at HMP East Sutton Park speaks for itself. DDN heard Sylvia’s story.
My mother was alcoholic as I grew up, and I was in charge of my siblings. I hated alcohol and never thought I’d be an alcoholic.
I got married and started drinking because I was lonely – my husband worked a lot. My drinking pattern progressed and I became more depressed, then hooked on antidepressants from my GP. I had my first cocaine at 30 and it got progressively worse.
I had three children when my husband asked me for a divorce. I was drinking in public toilets and was found guilty of causing grievous bodily harm with intent. I was looking at nine years.
I knew going to prison would save my life. I was taken straight to healthcare at Bronzefield, very unwell, drunk and on diazepam and suffering from pancreatitis.
When I was accepted at Send Prison, Forward couldn’t wait to get me onto their RAPt Wing.
I stayed there for five months and the peer support was amazing. I thought, ‘that’s what I want
I didn’t trust social services and police before – I’ve been let down so much. But coming to East Sutton Park, I was able to work and build up my trust.
I volunteered and have now been on an apprenticeship for seven months. It’s hard work but I love it and I’m gaining confidence to work elsewhere. I find it amazing that I am where I am and I’m very grateful.
Forward have supported me to live out my dream. I have my own flat, my own cat. I am responsible for my children. I am needed. I’m on a licence, but I’m trusted to live my life.