Improving systems to ensure that people leaving prison are motivated and supported to engage with community services is a priority for both the government and the sector. Ilo Edwin and Sarah Clowes describe how the Forward Trust is trying to address the challenge.
The high risk of relapse and reoffending amongst substance-misusing offenders and their susceptibility to drug-related death in the period following release from prison has been understood for many years, and underlined by the 2017 evidence review of drug treatment in England. Therefore, an integrated and seamless care pathway from prison to the community is necessary to both reduce risk for those recovering from substance misuse and address reoffending rates.
With more than 30 years’ experience of delivering services across the prison estate, The Forward Trust (formerly RAPt) recognises the importance of continuity of care (CoC) in reducing risk, and achieving and/or maintaining recovery goals. We strongly believe that continuing support following release contributes to enhancement of wellbeing and subsequent reduction of overdose risks. One example: more than 20 years ago Forward established a team of volunteers to act as a ‘meet and greet’ service at the prison gate – overseen by our recovery support team – and accompany people to community appointments.
Sarah recalls why she stayed with the Forward Trust having started as a volunteer in 2012. ‘I attended a RAPt event as we were then presenting on through-the-gate,’ she says. ‘It was this presentation that inspired me to apply for a job with Forward, seeing the care and responsiveness to the needs of those leaving custody and/or indeed involved with the criminal justice system. I share the belief that we need to collectively address these issues if we were ever to reduce re-offending’.
More than ten years later, Forward’s determination for supporting CoC continues. Forward now manages three RECONNECT services (Suffolk, Norfolk and Essex), which reinforces our mission to contribute to reducing inequalities faced by those leaving custody and the impact this has on their health, wellbeing and re-offending rates. RECONNECT practitioners conduct bespoke needs assessments up to three months before release and supports people to integrate into the community and access the services they need to reach their full potential.
Recent data shows that successful continuation of treatment from prison into the community remains low, however. Undoubtedly work to embed the government’s Guidance for improving the continuity of care between prison and the community was impeded by COVID, with release planning and CoC practises having to be adapted accordingly.
The key areas of challenge to CoC from our experience include:
- Unknown and/or wider geographical release areas, which delay community integration.
- Limited or no accommodation options for released prisoners.
- Unplanned releases from court, impeding services’ ability to make referrals and community pick-ups.
- Varying interpretations of ‘structured treatment’ between community and prison providers – we’ve seen that prioritising only those on OST as being in structured treatment presents a challenge to CoC efforts.
- In response to the new CoC target of 75 per cent, Forward Trust’s service development team, alongside service managers, worked on a CoC best practice strategic framework to support services to achieve the best-post release outcomes for their service users, providing structure, guidance and support to our prison and community-based employees.
Alongside this, within prison service delivery we have:
- Embedded through-the-gate workers (where funding permits) to support with release planning and follow-up engagement on release, as well as supporting re-engagement where necessary and signposting/referral to support services.
- Managers proficient in training staff on CoC procedures are actively identifying their main release areas in order to build relationships/CoC protocols. For example, our service manager at HMP Wormwood Scrubs chairs a bi-monthly CoC forum with key stakeholders across London, and our Brixton service manager carries out ‘data match’ meetings with key release areas.
- Practitioners who are dedicated in liaising with other key agencies such as OMU and dependency and recovery staff, flagging barriers and utilising digital technology, telephones and face-to-face methods to facilitate post-release appointments.
- Continuing the ‘meet and greet provision’ by our recovery support service.
Undoubtedly, the sector is responding positively towards the 75 per cent target. We have seen the input of Collective Voice London workshops, centred on CoC, and also Surrey county’s drive towards improving communication and partnership working – of which Forward Trust are committed members.
But more effort is needed to drive forward treatment retention and recovery outcomes. Reaching this target is ultimately dependent on the motivation of prisoners to want to stay in positive and meaningful contact with services, which in turn is dependent on what happens while they are in prison. Prisoners who are genuinely engaged in treatment, and motivated towards recovery, are much more likely to stay in contact with services.
Forward Connect peer support: nationwide community for current and former clients. Membership includes:
- Access to online mutual aid meetings, social activities, peer advice and support.
- Access to Fuse online learning platform containing self-help materials.
Reach-out service: Our online chat support function provides free, confidential advice on a range of issues including signposting to local support services.
Probation dependency and recovery service: Commissioned to support people on probation engage with relevant community substance misuse support upon release. Although its main focus is community engagement, each region has a number of prison link workers who are engaging with prisoners while in custody and who support continuation of care on release. Referrals for this service come directly from probation, and are an important link for prison substance misuse services by supporting teams with coordinating post release support.
Reconnect (Norfolk, Suffolk & Essex): A care-after- custody service seeking to improve CoC of vulnerable prison leavers by increasing access and uptake of support services for individuals who would otherwise struggle to engage – with a focus on engagement whilst in custody and supporting continuation on release.
Ilo Edwin is head of custodial substance misuse services and Sarah Clowes is regional manager for Essex services at Forward Trust.