Transcript Women with drug and alcohol problems: What works?

Women with drug and alcohol
problems: What works?
Gemma Lousley
Policy and Engagement Officer,
DrugScope
Women, the criminal justice system
and ‘Transforming Rehabilitation’
• Historically, women’s needs haven’t been well
recognised/addressed by the criminal justice system.
• Significant progress has been made since the Corston Report
(2007) – but a lot remains to be done.
• Offender Rehabilitation Bill, clause 11: “Place[s] a statutory
requirement on the Secretary of State for Justice to ensure
that the contracts with the new providers of probation
services consider and identify the particular needs of female
offenders, so that the issue will be expressly considered when
commissioning rehabilitation and supervision services”
(Government response to Justice Committee report on
women offenders – October 2013).
Background facts and figures
• Corston Report (2007): “Drug addiction plays a huge part in
all offending and this seems to be disproportionately the case
with women. Around 70% of women coming into custody
require clinical detoxification compared with 50% of men.”
• Oxford University report (2006):
- 58% of female prisoners had used drugs daily in the six
months before prison; 75% had taken an illicit drug.
- Crack cocaine, heroin, cannabis and benzodiazepines = most
widely used drugs. Crack and heroin most likely to be used
daily.
- 42% of women in prison drank alcohol in excess of
government guidelines prior to imprisonment (comparable
figure of 22% of general adult female population).
• 48% of women using women’s community projects have drug
or alcohol problems.
Background facts and figures
• Clear, though complex, links between substance misuse and
domestic violence; women who have experienced genderbased violence are 5.5 times more likely to be diagnosed with
a substance use problem over their lifetime.
• Links between substance use and involvement in prostitution
e.g. Drug Treatment Outcomes Research Study (2007) –10%
of women commencing drug treatment said they had
exchanged sex for money, drugs or something else in past
four weeks.
• Women will be disproportionately affected by new licence
and supervision proposals for short-sentenced prisoners
under ‘Transforming Rehabilitation’, as more likely to serve
short sentences. In 2012, those entering prison to serve 12
months or less = 71% of all women entering prison under
immediate custodial sentence (men = 57%).
What works?
• What works for women with substance misuse problems to
reduce reoffending? Very little quantitative evidence/
evidence in terms of outcomes.
• BUT: quite a lot of qualitative/narrative evidence of what
appropriate service provision for women with drug and
alcohol problems is/what ‘good’ looks like.
• Ministry of Justice: “In the absence of decisive evidence,
partners will want to have a sound theoretical rationale for
their approaches, and will want to draw on the extensive
insight and learning offered from a range of different research
types, both qualitative and quantitative, to inform their
thinking” (‘A summary of evidence on reducing reoffending,
2013).
Women-only provision
• Can mean women-only services, but also women-only spaces
or times in generic provision; importance of access to female
keyworkers, too.
• Can help women to ‘open up’ and discuss issues affecting
them.
• Also about women’s safety in treatment: may be vulnerable to
exploitation or abuse by men using the service, or may find
themselves coming into contact with abusive partners
/former partners in the service environment.
• Concerns re Drug Appointment Requirement in Offender
Rehabilitation Bill: if women-only provision isn’t in place,
women could be mandated to attend inappropriate,
potentially unsafe provision, with threat of breach if don’t
attend.
Childcare/demands of women’s lives
• Women very often primary or sole carers for children:
demands of this can have a very real impact on women’s
ability to attend appointments and engage with support.
• Importance, therefore, of childcare provision/support with
childcare arrangements.
• Need to recognise demands of their lives in other ways – for
instance:
- Sensitive timetabling of appointments (e.g. Drug
Appointment Requirement)
- Not overloading/‘setting them up to fail’ (e.g. Rehabilitation
Activity Requirement)
Multiple needs
• Women with drug and alcohol problems rarely just have
substance misuse problems – there are often a range of
associated and interlinking problems that need addressing.
• ‘Challenge of Change’, DrugScope and AVA report on women
involved in street-based prostitution and substance use –
highlighted mutually reinforcing nature of involvement in
prostitution and substance use; some women explained that
they were selling sex to support their partner’s drug use, too.
• Importance of holistic, integrated provision that addresses
range of needs women have to support them to make
positive, long-lasting changes in their lives.
• Strong partnership working can help to deliver this, but there
are clear advantages to the ‘one-stop-shop’ model.
Women and peer support
• Peer support: popular theme throughout development of
‘Transforming Rehabilitation’ proposals, and already quite
widely used across the drug and alcohol treatment sector.
• Importance of ‘real peers’ – e.g. for women who have
substance misuse problems and are involved in street-based
prostitution, provision of support by women who have also
been through these experiences.
• ‘Real peers’ and importance of women-only support; also
issue of stigma/‘double stigma’.
• Provision of ongoing and robust support for peer mentors
themselves is also key.
Resources
Corston Report (2007):
http://www.justice.gov.uk/publications/docs/corston-report-march2007.pdf
DrugScope and AVA, ‘The Challenge of Change: Improving
services for women involved in prostitution and substance use’
(2013):
http://www.drugscope.org.uk/Resources/Drugscope/Documents/PDF/
Policy/Challenge%20of%20change_policy%20briefing.pdf
DrugScope/LDAN, ‘Making the connection: Developing
integrated approaches to domestic violence and substance use’
(2013):
http://www.drugscope.org.uk/Resources/Drugscope/Documents/PDF/
Policy/DVReport.pdf
Stella Project – addresses overlapping issues of domestic and
sexual violence, drug and alcohol use and mental health:
http://www.avaproject.org.uk/our-projects/stella-project.aspx
www.drugscope.org.uk
[email protected]