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EXECUTIVE SUMMARY
Background
One of the most striking penal phenomena in Scotland during the last decade has been the steady increase in the numbers of women in custody. This, combined with a series of suicides at Scotland's only prison for women, HMP and YOI Cornton Vale, resulted in a wide-ranging review of the use of imprisonment and non-custodial sentences for female offenders. The review concluded that the backgrounds of women who offend and the circumstances which lead to their offending meant that prison was, for the most part, an inappropriate and potentially damaging disposal for this group. It produced a number of recommendations aimed at keeping women out of prison where possible and at improving the conditions for those who were, by necessity, detained. An Inter-Agency Forum was set up to establish services for women in the criminal justice system.
The Inter-Agency Forum recommended, among other things, the creation of 'Time Out' Centres to provide residential and non-residential support services for women. The theory was that female offenders should be able to get 'time out' of their normal (chaotic) environment without resorting to 'time in' custody, where many of them were being placed. The work of the Forum was subsequently taken forward by The Ministerial Working Group on Women's Offending. The 'Time Out' Centre, or 218 as it is now called, was established in August 2003 with funding from the Scottish Executive and opened its doors to women in December 2003.
The research
The research summarised here evaluated the initial stages of 218. The aims of the research were to:
- evaluate the operation and effectiveness of 218;
- highlight examples of good practice and identify areas for improvement;
- determine the extent to which addiction and offending can be addressed together;
- assess the success of 218 in linking women into mainstream services on departure;
- assess and determine the effectiveness of the Centre in relation to costs, outcomes and overall effectiveness in achieving its stated objectives.
The evaluation was conducted through an analysis of material from documents and project records; focus groups and individual interviews with service users; and interviews with project staff and key stakeholders, with interviews repeated after one year where possible. In total 5 focus groups and 66 individual interviews were conducted with service users. Twenty-four interviews were conducted with staff at 218, and an additional 80 interviews were conducted with key stakeholders.
Implementation issues
218 was designed to address the needs of female offenders in Glasgow in order to reduce reoffending and consequently to reduce the number of women who end up in custody. As such it is an innovative project, responsible for providing services for women involved with the criminal justice system in a relatively unique way. Initial funding has been significant compared to that for other criminal justice services of this size and, despite some minor problems with the layout of the building, the resources have been appropriate, ensuring that the Centre has made the planned services available to clients. 218 hosts a range of services in-house. This has created both benefits to service users, who are able to access support from different agencies in one location, and a number of difficulties in the staffing and managerial structures, some of which have yet to be resolved. These difficulties are generally related to multi-agency working and the management of multi-professional teams and are not unique to 218.
218 as a resource centre for female offenders is the first of its kind. To some extent this has meant programmes, and tools for monitoring these programmes, have been developed pragmatically, evolving over the initial period of service. This has meant that the service as it operated at its inception in December 2003 was quite different from the later structure. The operational changes at 218 posed problems for the evaluation, as the service that existed at the end of the evaluation differed considerably from the one that existed initially. It has also been a challenge to ensure that agencies 218 was intended to serve - namely criminal justice agencies - were aware of its existence and the client group to which it was intended to respond.
The initial operational objectives of 218 and systems for monitoring these were criticised by key stakeholders as lacking clarity from the outset. The project joined together 2 main service providers (Turning Point Scotland and the NHS) without defining clear responsibilities or decisive means of overseeing service provision. Arguably an important problem in overcoming this ambiguity was the lack of a Monitoring or Advisory Group to carry forward the work of the initial Commissioning Group. Such a group, though planned, only came into existence 18 months after the service was operational and had yet to develop an active role.
Referral
Women were referred to 218 from a variety of sources. While many of these were not direct referrals from criminal justice agencies, the majority were related to criminal justice services in some way. Some women needed to be referred a number of times before they engaged in the service. The initial court assessment and 3-stage formal process of assessment was designed to distinguish between those who were ready to engage and those who were not. The women referred to 218 were involved in the criminal justice system, and all were clearly vulnerable women at (usually immediate) risk of physical and psychological harm. The characteristics of service users replicated those of women who end up in prison in Scotland, indicating that the target group for referral and engagement have been identified appropriately.
Referrals from pivotal criminal justice sources such as sentencers did not begin until 218 had been in place for over a year. This meant that initial referrals often related to women who were considered by stakeholders to be 'on the path' to custody rather than at immediate risk. Women who referred themselves to 218 often defined themselves in this way too or, more often, believed they were likely to die without some sort of meaningful help. As the service developed, the proportion of direct criminal justice referrals increased, with more women accessing the service as a direct alternative to custody. However it is important to note that the service was initially developed to prevent reoffending, to provide alternative methods for dealing with women in the criminal justice system, and to tackle the underlying causes of offending behaviour.
Of the 343 women referred to 218 between 1 April 2004 and 31 March 2005, 143 women engaged with 218 at least once. Levels of engagement were highest among women referred by non-criminal justice agencies; however, referrals from such agencies were often offence-related ( e.g. supporting women to exit prostitution).
Service provision
218 is viewed as a distinctive service which provides 'holistic' care for women involved with the criminal justice system. This has required the co-operation of staff from different agencies and with distinctive professional backgrounds. Joint working had led to some difficulties during the implementation of the service in terms of management responsibilities and the role of individual workers. These tensions are invariably a feature of inter-agency working and have been reflected in the operation of diverse professional teams elsewhere. Initial tensions were evident, relating to the management and monitoring of the Centre. There appeared to be an absence of 'joined-up' planning at senior levels, noticeably in relation to health care. Delays in the establishment of a Monitoring/Advisory Group exacerbated this, and the absence of such a group appeared to limit a more structured oversight of the Centre. Despite initial difficulties with communication between different agencies, inter-agency working was viewed positively by respondents from 218 and other agencies, and workers expressed a clear commitment to delivering a unique and effective service
Service users actively praised the regime at 218 and believed it addressed their needs. Some criticism was made of policies regarding family contact and time out of the building for residential service users, but most women also understood and accepted reasons for restrictions. Staff also believed the support at 218 was appropriate and that its strength lay in the emphasis on relationships with service users. Some members of staff were concerned that time-limited service relegated the residential unit to crisis intervention, though longer-term support was available through the day programme.
Support was made available to enable women to address problematic substance use, from both health and addiction workers. This was viewed by service users and staff as a crucial component of the service. The availability of ongoing support was important in the prevention of relapse. Towards the end of this evaluation, increased emphasis was being given to programmes aimed at addressing offending behaviour. However interviews with all respondents illustrated the important correlation between substance use and offending. Notably, 52 women (83% of those interviewed) said their drug use and/or alcohol use had decreased or stopped (mostly the latter) at the time of interview. Reducing and/or ending substance use was considered an important way of reducing and/or ending offending behaviour. This is borne out by other relevant research (Hough et al, 2003, McIvor, 2004). This also had a significant impact on other areas of the women's lives, with 42 women (67% of those interviewed) providing specific examples of direct improvements to their health and well-being, as a result of attending 218.
Linking women with other services
Creating a holistic service to address the needs of female offenders is an ambitious prospect and not without its difficulties. Awareness of 218 initially seemed limited amongst agencies that were expected to have a keen interest in the programmes there. Staff were required to increase the profile of 218 while, at the same time, attempting to link women in with other services. This situation improved however, and 218 staff continued to make active attempts to inform key agencies and services of their work. The 218 Project was an ambitious attempt to link services across a number of areas. For the most part it had received full cooperation in doing so, though an important barrier was the lack of an inter-agency Advisory Group to assist 218 in its links with others.
Not surprisingly the interplay between services created some initial and ongoing problems, primarily in terms of structural relations and clarity of roles between managers and staff employed by Turning Point and those employed by the NHS. The lack of the planned Advisory Group for the project is likely to be part of this problem, though structural problems in the initial terms of service and ongoing ambiguity of required service outputs and outcomes contributed at least as much. Disagreements about the structure of the service remained entrenched with no overarching authority stepping in to clarify the terms of operation. Further effects of the absence of an Advisory Group were the difficulties in ensuring outside agencies were aware of and complied with operational agreements with 218.
Links with services to enable service users to move on from 218 were generally good, and important links had been established with social work departments and the Social Inclusion Partnership network. Twenty-one of the women interviewed, indicated that they had been referred to other services from 218 (including counselling, training or other support). More consistent problems existed in terms of finding suitable housing for service users and to some (often related) extent, accessing community-based prescribing services and addiction workers. Nevertheless, 16 women said that 218 had helped them find stable accommodation, when it had previously been unstable. Problems which arose were generally due to difficulties ensuring appropriate provision was available where and when it was needed, often at fairly short notice. Structural problems such as the use of project workers rather than designated outreach staff or external case workers to make such links also hampered attempts to link service users with resources outside.
Outcomes and effectiveness
The effectiveness of a service like 218 is often difficult to measure in quantifiable terms, particularly in light of its broad remit and pragmatic development. Statistics able to identify changes in sentencing patterns and criminal justice outcomes will not be available until the end of 2006, while any meaningful attempt to establish reconviction data requires a 2 year follow up period. Nonetheless, interviews with sentencers and prosecutors have shown that they make use of 218 and value it as a resource. In individual cases, referrals to 218, such as through diversion from prosecution or direct bail, often successfully prevented female offenders from entering custody, at least in the short term. Quantitative and qualitative data indicate that women who have engaged in services at 218 have been actively involved in offending and that they fit the profile of female offenders in custody. So it is likely that women who engage with services at 218 are avoiding custody in the short and longer term.
Cost-effectiveness is impossible to assess at this stage in the absence of measurable outcomes. In terms of costs comparisons, however, we can determine that the average cost per engagement at 218 (£7,701), equals the cost of 2.6 months in prison. The average length of stay at 218 was 2.6 months, but this is based on those cases where complete information was available. Data from project records on the length of time spent at the project was missing or incomplete for just over half of the women, often because they were still engaged with the project. It is also clear from this evaluation and other previous research that there are numerous benefits associated with the range and level of services provided at 218 which are not offered over the course of short-term custodial sentences. However, limiting measurements to quantifiable and immediate criminal justice outcomes misses the contribution 218 is likely to make to longer-term crime prevention.
Women who continue along the path of addiction and offending are likely to end up in custody if they fail to receive some sort of support. 218 has developed a model of intervention based on a recognition of the needs of women in the criminal justice system, which attempts to respond to those needs and in doing so, aims to tackle the root causes of offending behaviour.
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