1. Screening for learning disabilities in prisons Glynis Murphy, Tizard Centre, Kent Univ g.h.murphy@kent.ac.uk g.h.murphy@kent.ac.uk

2. Offenders with LD: prevalence Interpret data with care! Samples vary, methods vary! Eugenics era: assumed to be very high rates but little good data (eg assessed only those referred with problems; used incorrect norms) In USA: early studies showed 10% of prisoners have ID; recent studies: 3% & less In Australia: often get figures around 10% or more; higher in Aboriginal populations; affected by ethnicity? + lack of diversion possibilities?

3. Offenders & ID: prevalence In UK: studies in 1990s - police station: 5-9% acc to Gudjonsson et al - probation: 6% acc to Mason & Murphy 2002 - prison: <1% - Harnett, Holland & Murphy, ‘95 More recent UK studies suggested 7% of prisoners have learning disabilities – e.g. Mottram et al study in NW prisons – but methodology criticised Do exact numbers matter?

4. What prisons currently do In the No One Knows Programme, Jenny Talbot (Prison Reform Trust) asked prisons whether they screen people for learning disabilities or difficulties No routine screening going on at time (2008) Clear from rest of ‘No One Knows’ that prisoners with LD were very disadvantaged in terms of: accessing visitors, doctor appoint- ments, ordering meals, accessing work training, + accessing treatment programmes.

5. Bradley report Amongst other recommendations, asserted that prisons should screen for LD Clearly best to screen at entry to CJS – i.e. at police station – that is still (my) long term aim Meanwhile let us try screening in prison! Common objection: but what can we do if we find we have got prisoners with LD? Our answer: all sorts of things! - AND if you don’t know who has LD, how can you help them at all?

6. How can we screen? Common tools & requirements WAIS-IV - gold standard IQ test; takes 45mins-1hr; done by psychologists only WASI - short form IQ test; takes 20 mins; done by psychologists & a few others HASI – much like the WASI; validated in CJS; can train few others to do; over-estimates IQ LIPS – takes 15 mins; vocab & clock drawing; can train others to do it; validated in CJS LDSQ – 10 mins max; very easy to train others; validated in community

7. Dept of Health trial in 2010/11 None of tests ideal (adaptive behaviour issue) BUT: Used LDSQ to screen all new entrants to 3 prisons in a 3 mth trial Durham, Birmingham, Wormwood Scrubs Screening done by LD nurse in healthcare in Wormwood Scrubs; by DLO in Birmingham & by Education & Skills staff in Durham Done in first 48 hrs in W. Scrubs + Bham but later in Durham Overall positive ID for LD 7% - see next slide for exact numbers

8. Dept of Health trial PrisonNo. OfferedNo. refusedID as +ve for ID Birmingham1364 (85% of new prisoners) 195 (14%)59 (5%) Wormwood Scrubs 1099 (71%)58 (5%)89 (8.5%) Durham362 (57%)143 (39%)21 (9.5%)

9. What happened next? Up to each prison what they did when someone identified with LD Wormwood Scrubs: the LD nurse called up their local CLDT & invited them in to meet the person & do a full assessment Birmingham: 3 rd sector agency Care First worked in prison (doing activities like crafts) & followed people up when they left – those with LD referred to them Durham: ???

10. What else would we like to do? Train prison officers on what this means & what support the person may need Ensure support for person on literacy - eg to fill in forms for visitors, meals, doctor visits etc Ensure not bullied/harrassed/tricked Ensure wing officers aware (eg he may be struggling to understand, not being stroppy) Provide easy read info Provide access to work + treatment Ensure liaison with local services

11. What happened after the DH 3 mth trial? A hold up + Government change + austerity! Is it still the right thing to do? If yes, why arent we doing it? Is it just resources? (who pays for LDSQ forms? Who conducts the assessments? Who logs the data? Where? Who follows up?) Screening is a target for CLDTs & prisons......

12. Conclusions We know how to screen for LD We could negotiate reasonable price with test company We know how to liaise with prisons We have some ideas for what to do after people are identified We know its the right thing to do Lets do it!