Health Trainers in the Criminal Justice System By Geof Dart

‘The government says it wants to make society stronger by getting more people working together to run their own affairs locally, using volunteers and community organisations’. Big Society,( 2010)

Strategic Context Since 2009 within Yorkshire & Humberside a project has been developed through Offender Health & Social Care part of Yorkshire & Humber Improvement Partnership, implementing Health Trainers within the Criminal Justice System.

Probation Model Health Trainers: To train accredit ex offenders living within Wakefield & Bradford areas. Using Health Trainer Services to give full support and mentorship. 12 month training course working alongside probation

Prison Model Health Trainer Champion: To signpost to appropriate care pathways within prison settings required by their clients, RSPH level 2 Understanding Health Improvement. Physical education Healthcare Psychology Resettlement Carat worker

Why have Health Trainer Champions in Offender Health settings? 90% of all offenders have a diagnosable mental health problem, substance misuse problem or both. More than 80% of prisoners smoke. Dental Health in prisoners is poorer than in the general population. 20% of women in prison ask to see a doctor or nurse each day. 50% of prisoners have poor reading skills, 80% have poor writing skills and 67% have poor numeracy skills Before sentencing, 58% of prisoners will have been unemployed, and 47% are in debt at the time of sentencing.

Why have Health Trainer Champions in Offender Health settings? Health Trainer Champion services in an offender setting can impact on all seven pathways to reducing the risk of re-offending. These include: Alcohol and drugs Physical and Mental Health Employment training and education Accommodation Attitudes thinking and behaviour Finance, benefit and department Children Families and community support

Staff Impact

Offender Impact

Data Collection

Cost Effective Value for Money of Health Trainers. More responsibility for Health Trainer Champions in prison. Establishing reasonable assumptions upon which to base value assessments. Potential health gains Interventions, e.g. i. behaviour change ii. signposting iii. mapping of community services

Case Studies Royal Society of Public Health Brochure HMP Hatfield (male open prison). “Everyone I’ve met has come back and thanked me for my help and advice. It makes my day that I have actually made someone else’s day a better and healthier one.” Interview with Prison Health Trainer Champion by Altogether Better.

The Future Offender Health? Public Health? Prison GP’s? Social Enterprise?