1. Developing drug treatment services within the criminal justice system: the Greek case Gerassimos Notaras Sociologist, President of the Board of Management of KETHEA Ljubljana, EFTC Conference, 6-9 June 2007

2. 2 Presentation Overview 1. What is KETHEA? 2. Interventions in the correctional setting 3. Treatment in the correctional setting 4. KETHEA’s current network of interventions in the correctional system 5. Evaluation after 19 years of KETHEA’s interventions in the correctional setting 6. Current picture of the correctional setting 7. Planning the future

3. 3 1. What is KETHEA? Pilot Programme: T.C. Ithaki in 1983 Therapy Center for Dependent Individuals (KETHEA) started operating in 1987 KETHEA Today: in special consultative status with the UN Economic and Social Council (ECOSOC), member of the World Federation of Therapeutic Communities (WFTC), member of the European Federation of Therapeutic Communities (EFTC) one of the principal implementation organisations of the National Action Plan on Drug Addiction treatment in Greece

4. KETHEA Services Network 19Counselling Centres 16Treatment Programmes 12Rehabilitation Centres 18Family Programmes 14Prison Programmes 2Vocational Training Centres 1TC in Prison 2Prisoners’ and Ex-Prisoners’ Support Programmes 1Treatment Programme for Legal Addictions 1Multicultural programme for prevention and treatment 1Harm reduction programme, Drug free psychosocial intervention 1Legal support for the members 4Transitional schools Help line for relatives and friends of drug-users Prevention department Research and Training Institute Printing Unit

5. 5 1. What is KETHEA? 2. Interventions in the correctional setting 3. Treatment in the correctional setting 4. KETHEA’s current network of interventions in the correctional system 5. Evaluation after 19 years of KETHEA’s interventions in the correctional setting 6. Current picture of the correctional setting 7. Planning the future

6. 6 Law 1729/ 1987, art. 12, 13 and 14: special treatment of addicted drug users with legal problems KETHEA started implementing interventions within the correctional system (1988) After 19 years, law application has been discouraging Special correctional establishment only recently in operation (2002): 40 out of 4,500 addicted prisoners currently in treatment Alternative means were never implemented  KETHEA’s interventions from motivating to consultative In 2000 women’s prison in Korydallos (2002 National Action Plan)

7. 7 1. What is KETHEA? 2. Interventions in the correctional setting 3. Treatment in the correctional setting 4. KETHEA’s current network of interventions in the correctional system 5. Evaluation after 19 years of KETHEA’s interventions in the correctional setting 6. Current picture of the correctional setting 7. Planning the future

8. 8 Treatment in the correctional setting faced with a two-fold system conflict: Detainment Subculture KETHEA’s interventions: Without a specific legal framework, Without prior needs’ assessment of the population, Without evaluating and prioritising the needs and capacity of the penitentiary establishments, In a fragmented way, and dependent on each correctional establishment command With often cessations, up-settings and cancellations Corruption

9. 9 1. What is KETHEA? 2. Interventions in the correctional setting 3. Treatment in the correctional setting 4. KETHEA’s current network of interventions in the correctional system 5. Evaluation after 19 years of KETHEA’s interventions in the correctional setting 6. Current picture of the correctional setting 7. Planning the future

10. 10 ATHENS: Men’s Prison in Korydallos225206247225 ATHENS: Psychiatric Establishment for Prisoners25233135 ATHENS: Women’s Prison in Korydallos94819590 VOLOS: Penitentiary Establishment for Minors in Kassaveteia50595021 THESSALONIKI: Judicial Prison of Diavata191222229182 THESSALONIKI: Military prison of Diavata8455 THESSALONIKI: Judicial Juvenile Prison 13108 TRIKALA: Prison of Trikala 245442 KRITI: Prison of Neapoli 547479 KRITI: Prison of Alikarnassos 293540 KOMOTINI: Judicial Prison of Komotini 2661 AVLONAS: Juvenile Correctional Institution 527352 KASSANDRA: Rural Prison of Kassandra 2449 34332126 Prisoners’ and Ex-Prisoners’ Support Programmes People received services Counselling 2003200420052006 ATHENS: Counselling Centre as the Juvenile Court Total593767953911

11. 11 ATHENS: Therapeutic Community in the Women’s Prison in Korydallos322150 ATHENS: Released Prisoners’ Reception Centre6859117 THESSALONIKI: Support Centre for Prisoners and Released Prisoners409083 Treatment/ Rehabilitation/ Family Support200420052006 ATHENS: Family Support Programme6277102 Total202247352

12. 12 Conditions of Premises –Frequency –Members of staff PremisesFrequencyMembers of staff Men’s’ Prison in Korydallos25 m 2 NEUDaily Morning Afternoon 7 groups 95 persons HU + 2 TSM Psychiatric Establishment for Prisoners20 m 2 NEUOnce a week 15 persons per group HU + 2 TSM Women’s Prison in Korydallos150 m 2 NEUDaily Treatment, preparation 15 persons per group HU + 3 TSM + 4 T Juvenile Correctional Institution Avlonas2 rooms -35 m 2 EU -15 m 2 NEU 3 times a week 36 persons HU + 2 TSM Men’s Judicial Prison of Diavata40 m 2 EUDaily 2-3 groups of persons HU + 4 TSM + 1 T Women’s Judicial Prison of Diavata25 m 2 NEU2 times per week Therapeutic group and once a week traingin 13 persons HU + 1 TSM + 1T Juvenile Judicial Prison of Diavata15 m 2 EU5 persons;1 TSM Military Prison Thessaloniki10 m 2 NEUOnce a week 3 persons HU + 1 TSM Rural Prison of Kassandra45 m 2 NEU2 times per week treatmentHU + 1 TSM.+ 1T Judicial Prison of Komotini30 m 2 EU2 times per week 20 persons HU + 1 TSM Penitentiary Establishment for Minors in Kassaveteia 1 room EU2 times per week 12-15 persons 5 TSM in rotation Judicial Prison of Trikala12 m 2 NEUOnce a week 13-17 persons 3 TSM in rotation Judicial Prison of Neapoli8 m 2 NEU2 times a week, open participation2 TSM Judicial Prison of Alikarnassos15 m 2 NEU3 times a week, open participation2 TSM Judicial Prison of ChaniaIn a common room that used as kitchen-dining room Once a week 15 persons 2 TSM Prison Agios Stefanos -PatrasIn the library NEU2 times per week for 2 hours 40 participants, 0 waiting list 1 TSM [1][1] NEU= Non exclusive use [2][2] HU= Head of Unit [3][3] TSM=Treatment Staff Member [4][4] T= Trainers (paid by the hour) [5][5] EU= Exclusive Use [6][6] The programme is not operating temporarily due to the last riot that took place in the prison.

13. 13 1. What is KETHEA? 2. Interventions in the correctional setting 3. Treatment in the correctional setting 4. KETHEA’s current network of interventions in the correctional system 5. Evaluation after 19 years of KETHEA’s interventions in the correctional setting 6. Current picture of the correctional setting 7. Planning the future

14. 14 KETHEA’s interventions take place in very difficult conditions There is a sufficient number of inmates in the therapeutic and training groups. The number of inmates who receive counselling and motivation services, usually, and treatment services in two cases is very small in comparison to the total number of inmates. It is not possible to refer people to the second stage of treatment after they have completed the first stage of counselling and motivation A valuable generation of therapists has been created

15. 15 Skills were reinforced on a theoretical level KETHEA’s experience led to one major conclusion: Treatment in prison is possible. Effective treatment in prisons reinforced by two external evaluations A certain number of people, were admitted to KETHEA’s Rehabilitation Centres for Released prisoners in Athens and Thessaloniki

16. 16 Further conclusions These interventions contributed to the sensitisation of the people and the public opinion Good cooperation during these interventions, between the correctional personnel, the wardens and the therapists. Whenever disturbed, it was due to “interventions from above” Often the “system” intervenes in the efforts of the therapists. (prisoner transfer,humiliating behaviours towards the users and or “suspension” of the operation of the programme) Successful operation of the therapeutic interventions benefited the users in treatment and the overall prison population Every start is difficult!

17. 17 1. What is KETHEA? 2. Interventions in the correctional setting 3. Treatment in the correctional setting 4. KETHEA’s current network of interventions in the correctional system 5. Evaluation after 19 years of KETHEA’s interventions in the correctional setting 6. Current picture of the correctional setting 7. Planning the future

18. 18 199556 inmates per 100,000 people 199868 inmates per 100,000 people 200179 inmates per 100,000 people 200482 inmates per 100,000 people 200796 inmates per 100,000 people 71% increase of inmates in Greece between 1995-2007 43.4% foreigners in prisons (450/ 100,000) 44% are drug addicted offenders 50% sentenced for less than 5 years

19. 19 Penitentiary Establishments Capacity No of inmates on January 1 st No of inmates on May 1 st Prisons Alikarnassos105392404 Kekryra (Corfu)160278235 Patras780707775 (2) Trikala700707 (2)704 Chalkida120238234 Women’s Prison270541 (15)534 (15) Domokos Prison700-145 Jails (dikastikes) Thessaloniki370608 (11)620 (19) Ioannina80183230 Komotini105313 (1)328 (1) Korydallos6401941 (7)2052 (5) Kos4589 Larisa450845 (8)876 (8) Nafplio314502492 (2) Neapoli (Kriti)45118139 Prevadorio (Amfissa)100277125 Tripoli65171169 Chania67132130 Chios100160 Korinthos60 3942 1617 Central Prison Supply Storage (KAYF) 384442 Malandrinou440438373 Agrotikes Prisons Agias146141 Kassandras300254 Tiryntha200270 Juvenile correctional institution Avlona308288 (212)296 (196) Kassaveteia250162 (37)175 (29) Volos65116 (71)126 (82) Treatment institutions Psychiatry (Athens)160291313 Hospital (Athens)6066 (113)68 (141) KATK (Thivon)3004340 Total75431037010595

20. 20 1. What is KETHEA? 2. Interventions in the correctional setting 3. Treatment in the correctional setting 4. KETHEA’s current network of interventions in the correctional system 5. Evaluation after 19 years of KETHEA’s interventions in the correctional setting 6. Current picture of the correctional setting 7. Planning the future

21. 21 7. Planning the future KETHEA has planned qualitative and quantitative large scale interventions: In the action plan for 2007-2010, it included the evolution of interventions for addicted users, in the correctional system. It has already included in the budget of 2007 the necessary amounts for this year’s interventions. Since June 2006, it has suggested to the Ministry of Health integrating the interventions in the correctional system in the National Action Plan, which is yet to be announced.

22. 22 7. Planning the future: (cont) Since 2006, KETHEA is negotiating with the Ministry of Justice aiming at: safeguarding the interventions planned for the prison settings by KETHEA, planning approved regulations for the operation of counselling centres and treatment programmes, improving the conditions of the existing counselling programmes, creating new treatment programmes, creating relapse prevention programmes, for users- inmates, activating the provisions for alternative options instead of incarceration, for drug users and referral to a treatment programme outside the prison.

23. 23 KETHEA’s new interventions for 2007-2010 2007200820092010Total New interventions 2 counselling centres 2 treatment programmes 4 counselling centres 2 counselling centres 2 treatment programmes 1 social rehabilitation unit 1 legal support office 3 counselling centres 1 social rehabilitation unit 1 legal support office 11 counselling centres 4 treatment programmes 2 social rehabilitation units 2 legal support offices New staff members 40 members of staff 16 members of staff 39 members of staff 23 members of staff 118 members of staff Total cost salaries, operational costs €2,965,000.00€980,000.00€2,705,000.00€1,635,000.00€8,285,000.00