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CHAPTER 1: INTRODUCTION
Background
1.1 In 2000, Scottish Ministers published the Drugs Action Plan and set the framework for a ten year drugs strategy 'Tackling Drugs in Scotland: Action in Partnership'. The Action Plan aimed to increase the number of individuals referred into drug treatment at their initial contact with the criminal justice system. It is widely established that addiction problems are one of the main drivers for criminal behaviour in Scotland and there is evidence linking drug taking and particular crimes, for example, the abuse of heroin and crack/cocaine is often associated with acquisitive crime. More than three out of four people who receive a custodial sentence from the Courts show signs of drug abuse at the point of entry into prison and 70% of cases dealt with by the Scottish Courts are believed to be of a drug related nature. 1
1.2 Scotland's new national drugs strategy 'The Road to Recovery: a New Approach to Tackling Scotland's Drug Problem' was unveiled in June 2008. It reported that £94 million will be spent tackling drug use over the next three years. This represents a 14% increase in funding by 2010-11 and reflects the growing concern of drug use in Scotland.
1.3 Mandatory Drug Testing provides the latest example of a number of initiatives to reduce drug-related crime and to encourage problem drug users into the appropriate treatment and support services, thus breaking the cycle of drug use and offending. It follows on from such initiatives as Drug Courts, Drug Treatment and Testing Orders and Arrest Referral, further details of which can be found in Appendix A.
Principles of the Scheme
1.4 Mandatory Drug Testing aims to encourage problem drug users who come into contact with the criminal justice system to engage with treatment services as a means of addressing the individual's drug misuse problem and associated offending behaviour. Under the scheme, anyone arrested for defined 'trigger' offences (acquisitive crime and drug offences) are subject to mandatory oral fluid testing for heroin and/or cocaine. Those testing positive are required to undergo an assessment with a drugs assessor with a view to determine any dependency on drugs. Upon completion of the initial assessment, individuals who would benefit from treatment are introduced to drug treatment providers, although any subsequent uptake of treatment services is voluntary.
1.5 Mandatory Drug Testing of Arrestees pilots were implemented in three police stations in Scotland known to have high levels of drug use among arrestees (Edinburgh: St Leonard's, Aberdeen: Queen Street, and Glasgow: London Road), and is due to run until 11 June 2009 (total two year pilot).
1.6 The drugs test is for people aged 16 and over and tests for the Class A drugs, heroin and cocaine. For those who test positive, there is a statutory requirement for them to undergo a mandatory drugs assessment with a view to assisting them into treatment. The testing itself is carried out in police station custody suites using oral fluid samples, and results are available immediately.
1.7 In Scotland, legislation dictates that refusal of any part of the testing and assessment process without reasonable excuse constitutes an offence and is liable to criminal charge, resulting in a fine not exceeding £2500 and/or up to 3 months in custody. A summary of the legislation underpinning MDTA and a list of the trigger offences is presented in Appendix B.
1.8 The pilot sites are each operating using different models, and the processes being used in each area, their relative strengths and weaknesses and the efficacy of the three models were all subject to this evaluation.
The Evaluation
1.9 This evaluation sought to explore whether the pilot schemes, as originally conceived and implemented, were successful in encouraging drug users to engage with treatment services. It explored both the systems introduced and the activities undertaken by each of the main partners in delivery for the scheme.
1.10 The evaluation also sought specifically to provide a cost effectiveness analysis of the pilot schemes. This included a description of the spending on the pilots in each area, broken down into specific costs relating to the pilot, and analysis of the numbers of arrestees entering treatment services for the first time as a result of the pilot. An overall cost-effectiveness analysis was undertaken for MDTA alone and a comparison of the cost effectiveness of MDTA against Arrest Referral was also undertaken.
1.11 The evaluation ran for a five month period between October 2008 and February 2009, in parallel with the pilots' operation.
1.12 One of the aims of this evaluation is to allow evidenced based recommendations to be made on the future of Mandatory Drug Testing in Scotland, by providing an account of the perceived efficiency and effectiveness of the pilot schemes. That said, it is important to note that there was limited scope for an outcome evaluation using a more longitudinal research design, due mainly to the short period of time over which the pilots had been operating and the early reporting of the evaluation before the pilots had themselves reached an end.
1.13 Consequently, the focus of the evaluation was on the processes involved in the set up, implementation and operation of the schemes as well as the efficiency of the schemes, and, to a lesser extent, the outcomes and impacts for arrestees.
Research Methodology
1.14 Given the requirement for a process evaluation rather than an impact or performance evaluation, and the absence of reliable outcome data, the methodology adopted a necessarily audit focused approach employing methods such as secondary data analysis and desk based scrutiny of narrative data to explore historical developments with Mandatory Drug Testing, rather than using more projective techniques which explore likely future impacts of the schemes.
1.15 The MDTA pilot evaluation comprised three core elements, as follows:
Desk Research and Documentary Analysis - collation and analysis of written and numerical start-up information held by the three pilot schemes, including such documents as minutes of meetings, funding proposals, action plans and strategy documents, job descriptions for those employed in the pilots and operational documents. This involved collation and analysis of all throughput data held by the schemes (including demographic data for arrestees and drug use/offending history data), as well as national data held in relation to new entrants into drug treatment services;
Consultation Activity - principally, interviews with key stakeholders involved in the pilot schemes, including criminal justice and health professionals and arrestees; and
Costing Exercise - collection of appropriate cost data for analysis to allow comparisons to be made of the relative effectiveness of the three pilot schemes.
1.16 A large quantity of secondary data were provided to the evaluation team from the three sites, but was not presented in any uniform fashion. Each of the schemes were administered differently, with different management systems and procedures for collecting and storing monitoring data. Whilst efforts were made to standardise the hard data collected, to enable comparisons between the schemes, this was not always possible, and is noted where relevant in the analyses.
1.17 Primary data were collected by means of semi-structured qualitative interviews with each of the key stakeholders in each of the pilot sites. This included the police, assessors, drug treatment providers, Crown Office and Procurator Fiscal Service ( COPFS) representatives and other supporting service providers. A full list of consultees is provided in Appendix C and the interview schedules are presented in Appendix D.
1.18 A small number of arrestees who had been referred into the MDTA scheme also took part in the evaluation (four from Aberdeen, one from Edinburgh and four from Glasgow). The number of arrestees consulted was lower than initially hoped for, due mainly to problems identifying persons willing and available to participate. The evaluation took part in a period when the referral into assessment and treatment activity was especially slow, meaning fewer arrestees were available for recruitment. Further, although access to clients was sought via the various assessment and treatment provider agencies in each of the three sites, and was designed such that interviews could take place at times when service users were already accessing services, the attendance rate at pre-arranged meetings was poor. This was most likely due to the inherently complex and chaotic lifestyles of those subject to the MDTA scheme.
1.19 Whilst the sample of arrestees who took part in the scheme may not be considered as representative (ie no feedback was provided from those who chose not to take part in the test, assessment or to engage in treatment), the views of those who did engage fully from beginning to end still provided valuable insight into the ways that the scheme was received. Those who did participate were also asked to reflect on possible reasons why counterparts may not have engaged with the service, and this provided some useful understanding.
1.20 This aside, the research approach provided a comprehensive means of accessing and exploring all data and documents collected in each of the three areas, combining analysis of statistical data with attitudinal data from those involved in running or targeted by the schemes.
1.21 The costing exercise ran in parallel with the desk research and consultation activity, and drew upon data collected therein, as well as drawing on other data sources, such as financial data held by the Scottish Government.
Research Caveats
1.22 The evaluation began more than 12 months after initial implementation in each of the three sites, and, consequently, much of the data gathering has been retrospective. This does mean that the quality of some of the 'perception' data might not be as reliable as might be hoped, since much is dependent on the recollection of the partners involved. Further, due to some staff turnover among police, assessors and treatment providers across the three areas, some of the early observational data that might have been captured if the evaluation had been run in parallel with the pilot set up, has been lost.
1.23 The evaluation was also largely based around data provided to the team from the staff in the three pilot sites. The quality of data provided was a reflection of the systems in place to collect, store and manage the local data and these systems were, in turn, subject to the evaluation itself. This means that, in some cases, gaps in the data present not only limitations to our understanding of how the schemes worked but also point towards shortfalls of the schemes in their data gathering mechanisms. It is important to note, however, that no minimum standards of data required were set at the start of the pilots.
1.24 In addition to not being able to offer any reliable data regarding impacts of the pilots, the timescale of the evaluation has meant that the pilots will continue to run after the evaluation is complete. This means, therefore, that analysis of information and resource utilisation has had to be limited to a snapshot of the pilots, rather than for the whole period of their operation. It was decided that, for comparison purposes, a full 18-month period would be used for the evaluation, from the beginning of June 2007 (when the pilots were first implemented), to the end of November 2008. For costing purposes, a time period of June 2007 to March 2008 (financial year 1) and April 2008 to March 2009 (financial year 2) was used, with figures prorated to generate cost 'per head' figures.
1.25 Finally, whilst the evaluation seeks to compare the three pilots both against one another, and against the arrest referral scheme, the different models used in Glasgow, Edinburgh and Aberdeen mean that it is not possible to make entirely reliable comparisons, since there may be a number of variables linked to the different models which have directly impacted on numbers of referrals processed, and resource utilisation required. This means that any figures presented in the costing exercise that relate to 'per head' estimates, must be considered in the context of the infra-structural context in which the schemes are operating.
Report Structure Overview
1.26 The remainder of this report provides a description of the planning and implementation of the pilots in each of the three areas ( Chapter Two) and of the operation of the schemes ( Chapter Three). Chapter Four presents the cost effectiveness analysis undertaken as part of the evaluation, drawing on data presented in earlier chapters. The perceptions of the efficiency of the schemes from each of the main stakeholders involved in the pilot, namely, the police, assessor and drug treatment agencies, COPFS and arrestees is presented in Chapter Five.Chapter Six provides a discussion of the main findings from the research, and posits possible options for the future of MDTA in Scotland.
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