ISMG ~ Interventions and Substance Misuse Group Data challenges & opportunities: offenders in custody and the community Caroline Bonds (Head of Strategic Drug & Alcohol Treatment Team) & Robert Stanbury (Alcohol Operational Policy & Delivery Manager)

ISMG ~ Interventions and Substance Misuse Group Why does NOMS collect data? As a strategic tool that can be closely linked to planning processes Review the effectiveness of existing provision Identify problems and devise appropriate remedial action Measure performance against agreed targets and indicators Inform decisions about the commissioning and delivery of services

ISMG ~ Interventions and Substance Misuse Group What are the principal data sources? Community Offender Assessment System (OASys) Case management systems e.g. CRAMS, ICMS Offender Caseload Management Statistics NOMS Performance Hub Interim Accredited Programme Software (IAPS) National Standards Monitoring and Reporting Tool (NSMART) Research and evaluation Police National Computer

ISMG ~ Interventions and Substance Misuse Group

The nature and extent of the alcohol problem - community 44% of offenders had a current problem with alcohol use 48% with binge drinking 57% had misused alcohol in the past 41% had violent behaviour related to their alcohol use 47% were found to have a criminogenic need relating to alcohol misuse

ISMG ~ Interventions and Substance Misuse Group What Causes Their Offending? Over half of the offenders had ‘needs’ with regard to criminal history, education, training and employment and thinking and behaviour. Additionally, over half of offenders in custody were also assessed as having a ‘need’ with regard to lifestyle and associates, which encourage criminal activity. A much larger proportion of offenders in custody was assessed as having accommodation, drug misuse and attitudes problems than offenders on community sentences. As some factors, e.g. criminal history, cannot be altered, it is through factors like education, employment and substance misuse, that offending can be reduced. Criminogenic needs (OASys assessments 2007/08) OASys section Percentage of offenders assessed as having a need Community sentences (n=91,459) Custodial sentences (n=69,330) 1&2 Offending information* 52%68% 3 Accommodation 32%46% 4 Education, training and employment 53%60% 5 Financial management and income 21%29% 6 Relationships 39%44% 7 Lifestyle and associates 33%57% 8 Drug misuse 22%35% 9 Alcohol misuse 46%35% 10 Emotional well-being 42%36% 11 Thinking and behaviour 52%59% 12 Attitudes 28%44% Ave. no. of criminogenic needs Ave. no. of criminogenic needs excluding sections 1& * Offending information includes the current offence and criminal history. Some groups of offenders are unlikely to be assessed and OASys data should not be read as representative of the entire offending population

ISMG ~ Interventions and Substance Misuse Group What are the principal data sources? Prisons AUDIT DIR (DIRWEB) –facilitate and improve standards of continuity of care –support the monitoring and research functions around DIP –act as the SMTA in prisons CARATs Research Data Research and Evaluation

ISMG ~ Interventions and Substance Misuse Group Alcohol Use Questions on DIR

ISMG ~ Interventions and Substance Misuse Group Alcohol and prisons (1) Office of National Statistics (ONS) research found that:-  63% sentenced males and 39% females were hazardous drinkers in the year before prison  70% of young adults  Around 8% have intensive treatment need CARAT research data found that:  36% used alcohol in the 30 days before custody  14% reported alcohol as the main problem drug

ISMG ~ Interventions and Substance Misuse Group Alcohol and prisons (2) Data from a 2004/05 study showed that up to 1 in 5 CARATs clients regarded alcohol as their main problem drug/substance A study of problem drinking among minority prisoner groups showed that: –A third of women had increasing risk or higher risk patterns of drinking alcohol –Harmful levels of alcohol use featured prominently amongst adult male prisoners –Half of males from minority ethnic groups were drinking at increasing and higher risk levels of alcohol, with just over a third classified as both harmful drinkers and dependent on drugs Data from SPCR showed that: –36% reported heavy drinking prior to custody; –Heavy drinking was significantly more likely among prisoners sentenced to less than a year (39% vs. 31%) –16% of sample self-reported a requirement for support for an alcohol problem

ISMG ~ Interventions and Substance Misuse Group Assessing Need - Prisons All prisoners receive an Initial Healthcare screen Drug Clinical Assessment (initial SMTA – DIR) CARATs (SMTA) AUDIT – optional tool CSMA – for those whose alcohol misuse is part of poly-drug misuse Psychometric testing for intensive rehabilitation programmes OASys - Two thirds of prisoners will not be given an OASys Assessment

ISMG ~ Interventions and Substance Misuse Group Assessing need - community Areas should undertake a comprehensive assessment of offender need to:  Increase their knowledge and understanding of the offender (drinking) profile  Increase the correlation between identified alcohol need and service provision  Influence externally commissioned alcohol services to reflect offender need Should comprise analysis of data from OASys and alcohol screening tool/specialist assessment data PCTs and Local Authorities should include the needs of offenders in their area (both in the community and prisons) within their assessments for the alcohol component of the Joint Strategic Needs Assessment (JSNA)

ISMG ~ Interventions and Substance Misuse Group Performance Monitoring - Community From April 2008 an alcohol treatment requirement (ATR) completion target was introduced into the NOMS performance metrics to drive up commencements and completions nationally From 09/10 the main ATR metric is the completion rate with a supporting volume completions diagnostic measure:-  Completion rate – Minimum of 40% in each area  Volume – Minimum 100% increase on aggregated 08/9 target (1876) The Sentence Plan Outcomes Shadow Measure uses data from OASys to focus on the requirement for sentence plans to ‘deliver against needs’ by addressing the needs which are most likely to reduce re-offending

ISMG ~ Interventions and Substance Misuse Group Monitoring outcomes: Measuring impact on offender health and behaviour change Retention rates and compliance with order Satisfactory completion of the intervention and any associated community order/suspended sentence order/licence requirement(s) Changes in the level of alcohol use (measured by AUDIT/Offender Assessment System (OASys) Sentence Plan review/outcome data) Improvements in health and social wellbeing e.g. family life, accommodation, employment status, etc. Changes to alcohol related risk of re-offending (measured by OASys data)

ISMG ~ Interventions and Substance Misuse Group Target Setting and Performance Monitoring - Prisons With no central funding few targets have been set Performance monitoring of Alcohol 12-Step programme and Alcohol Violence Reduction Programme Measure starts and completions targets

ISMG ~ Interventions and Substance Misuse Group Challenges: What are the main limitations of existing data sources? Lack of routine, systematic and integrated data that is collected on alcohol - NATMS NOMS does not have nationally collated data from a validated alcohol screening tool (AUDIT still an optional tool) Over reliance on OASys as a tool to assess need Missing data/Invalid assessments Replication of data collected (Healthcare – CARATs) No single unified case management system Operational burden of data collection Issues around sensitivity of data/data sharing Not in a position to provide a detailed epidemiology and provision/gap analysis from existing data sources No direct and routine monitoring of treatment need across prisons and probation Spending by PCTs on alcohol treatment not reported routinely No central record being kept of which prisons offer locally funded alcohol treatment

ISMG ~ Interventions and Substance Misuse Group Opportunities: A brighter future? Drug Treatment Demand Model DIRWEB National Alcohol Treatment Monitoring System (NATMS) Research studies  ICPR research to assess the effectiveness of probation work with alcohol misusing offenders and CARATs Research  Offender Management Cohort Study  Revised alcohol interventions guidance Alcohol Learning Centre -