POLAR The development of an integrated intervention pathway in prisons

Date of Webinar: 9th April 2024.

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About this webinar:

People in the criminal justice system, including police custody, courts and prisons, have often experienced adverse and traumatic events in childhood, such as physical, sexual and emotional abuse and neglect. These developmental experiences in turn increase the likelihood of re-traumatisation in adulthood, through later experiences such as physical violence. They are also highly associated with substance misuse, mental health difficulties and complex social issues such as homelessness.

The estimated prevalence of post-traumatic stress disorder (PTSD) amongst people in prison is 7.7%, and for Complex-PTSD amongst people in prison it is 16.7% (Facer Irwin et al., 2021). People in prison and the criminal justice system who have experienced developmental trauma are often most in need of effective mental health services, but are also likely to face barriers that prevent access to this care (Home Office, 2007). These barriers include short stays and transition within the prison estate and into community services, being on remand and awaiting trial, and high levels of uncertainty about future charges (Forrester & Hopkin, 2009). In addition, there can be a lack of capacity within prison mental health services to provide the evidence based psychological therapies for PTSD and Complex-PTSD that is required to stabilise and manage these conditions (Forrester et al., 2014). Co-occurring substance misuse and complex mental health presentations often require specialist, individualised multi-disciplinary care. In addition, the prison environment can itself be counter-therapeutic and re-traumatising and may prohibit recovery from traumatic stress (Bradley, 2021).

There have been a number of programmes, pathways and initiatives within the Welsh prison estate and criminal justice system, as well as bespoke training programmes within individual services. Early scoping work has shown that there is variability in approaches offered and a disjointed picture across the system. In addition, there may be difficulties in ensuring sustainable implementation. There is also variability in whether interventions and approaches are evaluated; inconsistency in terms of the types of outcomes that are measured; and a lack of clarity about outcomes that are meaningful for service users and staff.

In collaboration with Welsh Government, Traumatic Stress Wales, Cardiff University and Greenwich University, we have been carrying out a project entitled ‘the development of an integrated intervention pathway in prisons’ (Polar). The aim of the current project was to survey existing services to understand what provision is currently in place and how this is delivered, to undertake qualitative work to complement this understanding, to describe gaps and barriers to implementation, and to understand views regarding an optimal pathway.

Speakers:

  • Andrew Forrester – Professor of Forensic Psychiatry at Cardiff University
  • Natasha Kalebic – research assistant in forensic psychiatry at Cardiff University
  • Jack Tomlin – Senior Lecturer in Criminology
  • Clare Crole-Rees – Consultant Psychologist within Oxford Health NHS Foundation Trust
  • Lewis Jones – Psychotherapist and High intensity Psychological Practitioner

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