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Abd Al-Rahman Drugs and Diversity Advisor HMPS (London Area)
Page 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 20 Introduction Objectives Key Targets Methodology Meetings with key Stakeholders Wandsworth Scrubs Drug Strategy Meeting Substance Misuse Throughcare Co-ordintor CARAT Service – HMP Wandsworth RAPt – HMP Wandsworth Healthcare – Substance Misuse Team Mapping of treatment pathways at HMP Wandsworth Wandsworth Prison Statistics And Monitoring System Race Relations and Diversity Workforce planning issues in the substance misuse sector in London The RRAA 2000 and the BME Prison Population in Wormwood Scrubs Conclusion Recommendations References & Literature Review Appendices 1 1 1–2 2 3 3 3-4 4–6 6–9 9 - 10 11 12 12 - 13 13 - 15 15 - 16 16 – 17 18 – 23 24 25 – 37
Introduction The Federation has been established as a national, membership body actively supporting the needs of BME professionals in the drug and alcohol field and their communities. The Federation also acts in a consultant advisory capacity to central government, informing the Updated Strategy (2002) from a culturally sensitive standpoint. The Federation have established regional committees to support regional government, other strategic partnerships and BME drugs & alcohol professionals to address the aforementioned gaps and meet the targets informed by the ten year drug strategy and updated strategy 2002, carried forward through its key drivers (Drug Strategy Directorate, National Treatment Agency, HM Prison Service, Drugs Action Teams, Crime Reduction Partnerships etc). The Federation, through its regional committees, will support the aforementioned stakeholders to deliver joined up and inclusive services which meet the support needs of the ‘whole community’. The regional structure is based on government models of best practice, which allow for the step-organic model of change management as detailed in the ‘Change Here’ booklet produced by the Audit Commission. The Federation will ensure the drug and community safety related needs of BME communities and wider communities are represented locally, regionally and nationally. Objectives This report seeks to inform HM Prison Service (London Area) and The Federation (London) Regional Management Committee (RMC) of the contractual outcomes achieved to date. This report represents performance of the Drugs and Diversity Advisor (London Area) in relation to the contractual outcomes for the period October 2003 – December 2003. The Outcomes to date can be measured by the requirements of the Key Targets agreed with between HMP (London Area) and The Federation, for the period outlined above. 1 Key Targets Key Target 2 Review Area and DSU data collection on BME use of drugs services.
See Key Targets and Work Programme (Appendix 0.01)
3.2 • 3.3
Key Targets 3. Review and evaluate service diversity training for service, employed staff. Visit 6 named establishments; report on findings Key Target 4. Offer the contract drug services consultation and support their training needs and operational considerations to assist complying with the prison service duties and policies on diversity • Produce and distribute letter of introduction to Service Managers of contract agencies (1) explaining context of prison service work, rationale and (2) offering Federation consultancy services2 Make recommendations on any necessary systems improvements. Highlight any indicated service shortfall or trends to be reviewed by steering group. Equality Health Check Process Update3. Information gathered during the visit also pertains to the Prison service Diversity training. This feedback will be included in a separate document focusing on Prison Service Diversity training and training needs of CARAT service providers after conducting a training needs analysis. Methodology. a). Meetings with key stakeholders to consider culturally sensitive service provision4 in order to consider the service provision in relation to BME prisoners in HMP Wandsworth. b). A mapping exercise to establish existing pathways and services available to drug using inmates (i.e. throughcare). c). Review of HMPS (London Area) prison statistics and monitoring systems. d). Consideration of workforce planning issues across the substance misuse sector; recruitment, retention and training of BME professionals. e). Consideration of the implications of the Race Relations Amendment Act (2000) in respect of the BME prison population in HMP Wandsworth. Culminating in a set of recommendations, which aim to assist the process of developing equitable, and quality service provision for BME inmates alongside the HMPS (London Area) Equality Health Check process and findings from the national CARAT service review.
See letter of introduction (Appendix 0.02) See Equality Health Check Update 4 See list of meetings (Appendix 0.03)
Meetings with Key Stakeholders Informal meetings with key stakeholders were held during the 8th – 12th December 2003. Discussions took place pertaining to the impact of the drugs strategy and intervention in relation to BME prisoners at HMP Wandsworth. The meetings were made as informal as necessary to facilitate the exchange of varied perspectives held by those concerned. Wandsworth Drug Strategy Meeting A meeting was arranged 12th December 2003 at 10.45am with the P.O. of Drug Strategy. However, on arrival at the prison the P.O. was not available due to unforeseen circumstances. After this, despite attempts, the DDA was not able to arrange a meeting. After numerous phone calls an email was sent with questions regarding drug strategy and intervention5. Substance Misuse Throughcare Co-ordinator (SMTCO) The DDA was informed by the SMTCO that her role is like a bridge between an Officer and treatment worker. Information and an application form that covers all services are provided on the wings. Application forms are picked up by the SMTCO who then fills in the relevant referral forms and assists inmates with making service access. As well as this the SMTCO gives advice and motivates inmates to help themselves. Crack users, many of whom are African Caribbean, not accessing services are usually referred to the CARAT team through this worker. However, it is the choice of the inmate whether or not they go through the CARAT team. The SMTCO in such cases refers directly to the required service. Those who have a long sentence will be picked up by the CARAT team within the last 8 months of their sentence6. It was said that 300 inmates are referred from the SMTCO per month approx 80 of which are referred to the CARAT team. The SMTCO stated that the RAPt programme is very effective and has assisted many inmates to achieve abstinence through a process change in their attitude and behaviour. However it was also said that when participants leave the programme and go onto the main wings it can be difficult for them as the majority of inmates have not gone through this process of change and are still often engaged in drug use. Inmates were said to be the best advert for RAPt but some who have forwarded
see Appendix 0.08 See 13 Mapping of treatment pathways Figure 2.
applications retract them if they have found work within the prison before their allocated place comes up. It was said that most prison officers would benefit from training on drug related issues in order to foster understanding of inmates with drug related problems and those involved in substance misuse intervention. Officers would, as a result of such training, become more emphatic and more effective in their role. The SMTCO also stated that feedback from others in regard to the way Diversity training is facilitated is poor and this served to make some attitudes even more distant from the aim of such training. CARAT Service – HMP Wandsworth The acting service manager informed the DDA that there are at present a total of 6 staff members one of which is on long-term sick leave. 3 more workers are due to start work soon including a new manager. The team has a lack of BME male and female staff. There is at present 1 part-time worker of mixed origin and 1 male non-BME worker who is hoping to move to Wormwood Scrubs CARAT team. It was said that it was not known why there was an all female team (apart from one male worker). When asked how the makeup of the staff team impacts on the work with inmates it was said that: 1) 2) 3) 4) they are sometimes seen as a ‘soft touch’. there is a degree of fear around seeing some inmates on a one-to-one basis. the staff make-up affected the perception of officers, who are mostly male, towards the team. The advantage of the staff make-up was that some inmates preferred to speak to a female as they saw them as more understanding.
There was concern expressed that there may be issues present in the work of the CARAT team but these cannot be identified because there are no full-time BME staff that may be able to “see particular issues from a different perspective”. The DDA was informed that induction into Wandsworth prison needs improvement. An officer was said to read from a sheet of paper describing services but with no ‘gusto’ leaving new inmates with little motivation to take in information. It was also said that there are no service leaflets in a variety of appropriate languages. This is the case even though some other London prisons stated that they have information in various languages.
After receiving a referral the CARAT team conducts an assessment and care-plan. Inmates can then be referred to Enhanced Thinking Skills (group sessions), AA, NA, Crack awareness group (run by CARAT team/nurses), Relapse Prevention session (3 day course), RAPt, GUM clinic, Dual Diagnosis nurse, acupuncture groups. Concern was expressed at the lack of pre-release groups to assist inmates with preparation for their exit. Referrals to groups were said to be good. Over half are said to be BME. However, no information was available in regard to numbers starting groups, attrition rates or completion figures. A new monitoring system came into place at the beginning of December 2003. Before this a manual tally had to be done in order to collate data including breakdown by ethnicity. Although time consuming this system was said to be more qualitative as opposed to the new system the data on which is seen as more quantative. The DDA was informed that for 9 months there was no admin worker and no ethnic monitoring. When asked what the London Area Office was receiving from the service for those 9 months the answer was not known. Figure 1 shows data from the CARAT team for December 2003. As can be seen the total number of crack users (Primary and secondary use) being assessed is 79%. The present crack awareness course lasts 1 week and, compared to crack groups within HMP Brixton or in the community, is far too short and not intense enough. The figures shown in terms of crack users, according to the SMTCO, are typical of most months. The priorities for the team are those inmates identified as a suicide risk, at risk due to self-harm, those on remand and those with 8 months or less to serve. All contacts with inmates are treated as if it is the last in case it turns out that it is. It was said that nothing has filtered down to the team in relation to QuADS or other quality systems related process. B wing is the Voluntary testing wing (unit). The CARAT team stated that on this wing everyone has a compact. However, other members of staff have stated that the wing is in the same condition it was in earlier in the year, as reported in the HM Inspectorate of Prisons Report7. The acting manager has attended prison service diversity training but could not remember much about the content because “nothing new came out of it in terms of learning”. One person walked out of the training disgruntled. It was also said that Cranstoun has not provided any diversity training to the Wandsworth CARAT team.
HM Inspectorate of Prisons ‘Report on an unannounced Inspection’ p.64
Fig. 1 CARAT Team figures for December 2003 Total assessments 84 B1, B2, B9 W1, W2, W9 A1, A2, A3, A9 M1, M2, M3, M9 Total BME Drug usage Crack/cocaine as primary drug Crack/cocaine as secondary drug Total crack users Heroin as primary drug Heroin as secondary drug Total Heroin users Used in last 30 days No fixed abode Release date 2003/2004 8.13 23 54 6 1 (27%) (64%) (7%) (1%)
30 (35%) 28 38 66 34 14 48 83 28 43 (33%) (45%) (79%) (40%) (17%) (57%) (99%) (33%) (51%)
The range of issues presented by inmates and matching services to assist them both within the prison and outside is cause for concern for the CARAT team. Through-care was said to be in need of development, particularly at the point of prison exit. The DDA was informed that as far as through-care is concerned a phone call is all that can be done at present. To make matters worse 33% of those seen in December by the CARAT team alone had no fixed abode and 51% had an earliest release date of 2003 or 2004. Also, it was felt that Counselling could be enhanced, i.e. more quality time to spend in one-to-ones. RAPt – HMP Wandsworth The acting manager (previously the Senior Counsellor) for the RAPt programme (Rehabilitation for Addicted Prisoners Trust) informed the DDA that the programme within HMP Wandsworth is accredited by the Home Office and Probation as well as being audited by the Joint Accreditation panel. The 3 month programme is abstinence-based using the 12 steps model of Alcoholics/Narcotics Anonymous (AA and NA) as its core. The programme has three phases:
Assessment, Education Pre-Admission; Lasting up to 8 weeks part-time. Allows all involved to assess suitability to the programme and prepares inmates for 2nd phase.
Primary Programme; Intensive (full-time) 12 week rolling programme with components familiar to provision within the community, i.e. within a residential rehab or day programme. Aftercare; Includes a part-time rolling programme of 12 sessions, ongoing through-care and release planning assessment. Aims at assisting inmates in remaining abstinent.
Those on remand are excluded from the programme. The criteria for programme entry are for inmates to be sentenced with 22 weeks or more left to serve. It was said that there is a greater ability to attract and employ male staff for the RAPt programme due to a 1 year training course provided by the organisation for those wanting to work in the sector, including exoffenders. This training has a lack of BME participants and as a result it was said that there are no BME workers within RAPt at the prison. This training is not yet accredited. When the DDA asked if RAPt staff work in a culturally sensitive way the reply was, “I’m not sure that RAPt does”. The DDA was informed that the team is aware of its limitations. For example, it was said that there was no BME staff member to perhaps give a view from different angle. This mirrored the view of the CARAT team. It was said that the lack of BME staff did not appear to impact on inmates and this was evidenced by the lack of racially sourced anger from participants on the programme. However, It was admitted that BME staff were required. It was also said that some differences in culture, attitudes and beliefs can be more difficult for some inmates to share in groups possibly making them appear as if they are not opening up and engaging. This was said to lead, at times, to the impression that they may not be right for the programme. The DDA gave the example of the rationale for adjustments being made in drug awareness sessions to suit the audience (i.e. between young people and adults or mixed groups and specific cultural groups) and whether adjustments would be made if there was a 90% BME group in RAPt. It was said that in such a case no adjustments in style would be made within sessions. This is because the 12 step model is said to be generic and and as such participants draw from their own cultural references, beliefs and understandings8. The 12 step model was said to be what was needed in all prisons partly due to extensive networks already existing outside of prisons.
see appendix 0.05
Figure 2 is a collation of an activity table given to the DDA on request and represents a sample period where full figures were available. The ethnicity of those leaving the Pre-Admission and Primary programme phases due to their own choice or being asked to leave was not included in the Activity report supplied to the DDA. As RAPt provides a rolling programme ‘new starters’ join already established participants. Fig. 2 Activity Table April 2003 – Aug. 2003 Applications received 97 Ethnicity 48 white, 17 Black-Caribbean 11 Black-African 14 Black-Other 6 Indian 1 Pakistani 49 (50.5% BME) 42 17 (40% 17 9 (52%) 5 (35%) 6 3 (50%)
Total BME Applications Total new starters on PreAdmission (Phase 1) BME Total new starters on Primary Programme (Phase 2) BME BME Completion of Primary Programme Total Aftercare Graduations BME Aftercare graduates 9.8
It was said that the Primary phase of the programme fluctuates between being predominantly White and predominantly Black. Black inmates tended to come at once. Asians were said to be rare on the RAPt programme and greater numbers would probably make contact if the team was more pro-active. It was stated that within staff meetings and within groups with inmates there is an ongoing exploration of issues that are linked to diversity. For example, discussions occur in regard to whether or not to bring in rules that seek to assist challenging and changing the perceived old drug related behaviour and language of inmates. It was admitted though that there are expressions and ways of being that are informed by cultural background
unbeknown to RAPt staff. It was said that these discussions are an important element to the process of treatment and communication between RAPt staff and inmates. 9.10 The RAPt manager informed the DDA that she had not attended Prison Diversity training but received feedback from others who had attended. Prison service Diversity training was said to be poor. Some attendees were known to walk out because, “the manner in which it is conducted is inappropriate” and as a result participants get defensive. The RAPt Head Office has provided an outline of available training that has a Diversity/Equal Opportunities session. However, staff are able to choose from this what sessions they want to attend. All staff were said to have received multi-cultural/Diversity based training on various University courses such as part of a Masters or Diploma. However, the DDA was informed that staff would benefit from training that focused on actually working more effectively with diverse groups. All staff were said to be enthusiastic about change and continued learning. Healthcare – Substance misuse team A meeting with the Senior Substance Misuse Nurse revealed that the work is to NHS standards but not directly under their management. A Wandsworth there is a 16 bed detox unit. 98% of those on in-patient detox are on methadone for stabilisation then discharged to D wing. Before discharge inmates have already received a CARAT assessment. It was stated that those who use only crack do not generally enter inpatient detox. For these inmates acupuncture is available as well as a one week crack awareness group co-facilitated with the CARAT team. Space for facilitating groups is said to be an issue. It was said that coordination is beginning to happen and E wing is to be set up as a post detox unit with a dedicated group room. The data in figure 3 was obtained from the Senior Substance Misuse Nurse and represents a snap-shot from November 2003. As can be seen BME detox figures, both in-patient and on the wings, are low. Substance misuse staff state that they see every new inmate with a drug problem. It was stated that approx. 100 of the 153 total drug and poly-drug detox’s used crack. In other words, crack users accounted for 65% of drug and polydrug detox’s. Since BME drug and poly-drug users accounted for only 11% of the total one would rightly question what happens to the other BME drug/poly-drug users?
Fig. 3 Detox Figures for November 2003 Drug, Polydrug and Alcohol Total Inpatient Detox’s 73 Inpatient Detox - BME 12% (9.5% ‘Black’, 2.5% ‘Mixed’) Total Detox’s on wings 104 Detox on wings - BME 10.2% (.9% ‘Mixed’, 2.7% ‘Asian’,
Total Drug and Poly-drug detox’s inpatient and on wings BME Drug and poly-drug inpatient and on wings Total Alcohol detox’s inpatient and on wings BME Alcohol in/outpatient 10.5
153 11% 24 12.5%
Concern was shown in regard a lack of structured programmes in place for those on remand and those on short sentences. Other concerns put forward: • • • • • • • More training needed for staff on running groups. Programmes need to be more intergrated within the prison regime. Work needs to be done in regard to co-ordination between prison regime and work of detox. Drug treatment not given high enough priority and resources until, for example, a death occurs. There are many instances found regarding MDT’s and inmates moving to heroin. The treatment system in the prison is reliant on inmates coming forward with their drug problems. More focus required on the specific needs of inmates.
It was said that the RAPt programme is a positive process for inmates but it excludes 90% of inmates due to the access criteria. For example, those on remand, short sentences and those who had problems with literacy. Crack and relapse prevention groups are also problematic for those lacking in basic literacy because written work is required. It was stated that HMP Wandsworth has a very good chemical detox considering the workload and staffing problems. However, It was acknowledged that more groupwork is needed. Groups were said to be well received by inmates with minor attrition rates because they have a short time span. African Caribbean take-up of groups is said to be high. However no evidence is available to prove this.
Mapping of Treatment Pathways at HMP Wandsworth Figure 4 below was put together from information received during meetings with service providers. Mapping services and the process in this way allows for ease in understanding what is available, to what level, for whom it is available and for ease in assessing where problems areas occur/are likely to occur. As well as this it facilitates ease of comparison with other Prisons. Fig. 4
Reception Healthcare Holding screening Identifyrooms drug users
Assessment completed by nurse
In-patient Detox clinic 16 bed. Referrals
Supplemented by Methadone programme on D-Wing (approx 20 inmates)
Referrals Referrals CARAT Team Referrals Crack awareness Conducted by CARAT team and Nurses 1 week course Relapse Prevention group 3 Day Course
RAPt PreAdmission Sentenced with 6 months minimum to serve RAPt Primary Programme Full-time12 weeks RAPt Aftercare Part-time 12 weeks
Wandsworth Prison Statistics and Monitoring Systems The monitoring system used, termed the ‘traffic light system’ allows disproportional representation in all areas of prison work to be highlighted to ‘Take Action’ or to give a ‘Warning’, as such the system itself appears effective. Contained in Fig.5 is information gained from the Diversity Officer and represents figures for December 2003. It was said that the figures are representative of the usual breakdown. Fig.5. Total Wandsworth prison population 1404 December 2003 BME prison Population BME (excluding Vulnerable persons unit) 620 (44.16) 511 (48.81%)
Asian 5.64%, Black 36.68%, Other 6.49%, White 51.19%
The Diversity Officer does not monitor drug related interventions. Due to this the summary data supplied by the Diversity Officer had ‘No data’ written under the following headings: Voluntary Drug Testing Unit, detox, CARATS, Drug testing programmes, Rehabilitation services and Mental health. ‘Take Action’ was stated on the following: total segregated days, Incentives and earned privileges, accommodation and Work Shops, Race Relations and Diversity The Diversity Officer, in post in Wandsworth since August 2003, stated that she is the first Black female P.O. in Wandsworth. The DDA was informed that the role is new at P.O. rank. The P.O. informed the DDA that she is bogged down with Race Relations due to many outstanding cases, there are 62 outstanding racial complaints from prisoners and 6 from staff. Complaints range from inmates reporting that they were physically assaulted by officers or other prisoners to complaints due to language used. It was stated that at times some officers communicate with inmates by using profanities.
Work was said to be frustrating at times because it is difficult to get things done in the prison. It was said that attitudes at Wandsworth are dated and the prison was not change oriented. The Diversity Officer stated that at present she does not sit on drug strategy meetings but thinks that she should and this has been discussed before. On the ‘traffic light’ reports held by the Diversity Officer Education figures showed that BME inmates are over-represented and some courses have waiting lists. However, drug testing figures as well as those for rehab services, CARAT team and healthcare had ‘no data’ written under their headings. When asked why it was said that these are held by drug strategy. The Officer has questioned this in the past. It was said that inmate turnover is too great to do in-depth work. Also, parole is possible if inmates address offending behaviour yet a programme focusing on this is not done in the prison. An Inspection report from early 20039 also highlighted this as an issue: “Offending behaviour programme awareness training should take place to increase understanding and encourage prison officers to participate in the delivery of the programmes.” P.138
In regard to diversity training It was stated that attitudes in relation to race have come out that were on the extreme side. The Diversity Officer has facilitated training at Wandsworth with mixed reviews. In the absence of evaluation materials it is difficult to properly gauge the effectiveness of Diversity training. Workforce Planning Issues in the Substance Misuse Sector in London Much of the information gathered throughout the process of this visit suggests that workforce developmental issues, present a significant challenge to HMP Wandsworth in relation to the successful implementation of its drugs strategy. As a consequence of this exercise, it has been established that HMP Wandsworth should not consider the implications of equitable drugs treatment and service provision in isolation, but within the broader context of challenges faced across the substance misuse sector as a whole within the capital. Health Works UK’s10 findings regarding the recruitment and retention of staff in the substance misuse field also supports this view. They describe the issue of recruitment and retention as:
HM Inspectorate of Prisons – Report on an unannounced inspection of HMP Wandsworth (2003) Health Works (UK) is a National Training Organisation for the health sector. They are currently developing national occupational standards for people working in the drug and alcohol sector.
“A national problem, largely due to overall shortages across the health and social care professions…the rapid development of the drug treatment sector – with new criminal justice interventions developing alongside the expansion of drugs commissioning and policy – has exasperated these pressures. Many agencies reported difficulties retaining staff due to new opportunities elsewhere. Such pressures are unlikely to diminish… Estimates suggest that the number of drug treatment specialists will need to increase by up to 50 per cent in the next five years to meet demand” 14.2 It should be noted that London demonstrates consistently higher rates of drug use than any other region in the U.K11 The Mayor for London established the Greater London Drug and Alcohol Alliance (GLADA)12 who in 2001 agreed that the crisis in recruitment, retention, training and workforce planning faced by the sector in London should be addressed as a matter of priority. As a first step, GLADA commissioned the Cranfield School of Management to undertake a systematic assessment of workforce requirements. The information generated by the assessment is being utilised to develop a human resource action plan for the specialist drug and alcohol sector in London. The Federation are members of GLADA. London and the South East of England have long been “hotspots” for recruitment difficulties and for pressures on all aspects of employment. Therefore, an important aspect of the research programme was to form an overall demographic profile of the sector in London. The Training Needs Analysis has generated a reliable profile of age, gender and ethnicity for different areas of the workforce population, its findings are as follows. In the area of service delivery (TNA A) the population breaks down broadly as: • • • 69% White, 16% Black and 7% Asian For managers (TNA B) the same three broad groups break down as 75% White, 13% Black and 7% Asian There is a small disparity between the practitioner ratio and manager ratio that implies ethnic minority workers, particularly from a black background, may have more difficulty progressing to management levels Ethnicity profiles for commissioners indicate an entirely White sample The community care assessors profile is 78% White
Audit Commission – Changing Habits (2002) GLADA is a London based partnership alliance established to provide a mechanism to tackle London wide problems and to promote better co-ordination of policy and commissioning of drug and alcohol services
• • 14.4
Gender profiles for practitioners reveal a majority of Female workers, the ratio being 61% Female and 39% male In the managers sample there are 45% Male and 55% Female
The National Treatment Agency has committed to recruiting an extra 3000 practitioners into the drugs treatment workforce, a significant number of which will be recruited from BME communities. Between 1991 and 1993 a much smaller increase in BME employees in the drugs field led to a 30% increase in disciplinaries involving BME staff. It is generally recognised that the majority of services have not developed the polices, processes, structures and professional competencies to deal with the challenges that will come with an increasingly diverse workforce13 and the communities within which they serve. The Race Relations Amendment Act (RRAA2000) & the BME prison population in HMP Wandsworth ‘Institutional racism consists of the collective failure of an organisation to provide appropriate and professional service to people because of their colour, culture or ethnic origin. It can be seen or detected in processes attitudes and behaviours which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people’. MacPherson The Task Force Review Report, NTA HR Strategy; Developing Careers, Updated Drug Strategy (2002), and National Scoping Study14; Delivering Drug Services to Black and Minority Ethnic Communities (Home Office), state clearly that the drug related needs of BME communities and BME professionals in the drugs field have not been met by drugs service commissioners and drug service providers. Lack of cultural competence (absence of culturally sensitive treatment modalities, lack of competent management support and developmental opportunities for BME staff), ineffective needs assessment/consultation with BME communities, inadequate HR/Performance Management Frames, inadequate data collection systems (ethnic monitoring is particularly poor), research gaps in relation to the specific needs of BME drug users and inadequately trained staff, particularly in relation to diversity, have been sighted as key areas in need of development if BME communities are to experience equitable access to drugs services and equal opportunity in the appointment to and development in professional roles within the drugs field15.
Federation Equality Health Check (2002) Sangster D, Shiner M, Patel K and Sheikh N (2002) 15 Ahmun V, 2000
The Federation Equality Health Check currently being carried out on behalf of London Area will recommend any necessary training, policy and/or procedural development that is required including a full race equality specific training needs analysis. The EHC uses an assessment tool that is DANOS and QuADS compliant and designed to compliment the RRAA(2000) related audit tools developed by local authorities, PCT’s and Criminal Justice Services across the country. The findings will be consolidated in a confidential report to HMP London Area. Conclusion There are aspects of service provision in HMP Wandsworth that have received excellent feedback from inmates namely the RAPt programme. Although the drawbacks are said to be that many inmates have too little information about it and the capacity of the programme is too small, inmates see the process as “the benchmark for treatment in prisons”. The BME population is able to access the programme in relatively high numbers and the treatment process mirrors provision within a community setting. Also, inmates saw the work of the SMTCO as crucial to their motivation and paving the way for their access into services. This role would make a good addition to provision in other prisons. However, There is not enough intervention on offer. Also, the information gathered suggests that drugs strategy and intervention as a whole within HMP Wandsworth lacks the required culturally sensitive approach to meeting effectively the drug treatment needs of its BME prison population as well a users of specific drugs such as crack. As was the case in HMP Wormwood Scrubs, findings suggest that the nature and level of provision does not provide the BME prison population with an effective response, particularly with regard to stimulant users and remand prisoners. In addition, it was found that treatment staff did not reflect the diverse prison population they seek to serve. Some treatment staff echoed these concerns. The HM Prison Service and in particular CARAT providers should encourage greater levels of diversity in teams. Diversity is a gateway to being more effective. Belbin (1981)16 talks about balance in a team, ensuring that a whole range of individual differences in areas such as skills, attitudes, attributes and personality is taken into account. The more diverse the team is in terms of shared interests, attitudes and backgrounds, the more potential for increased productivity and practice; thus fostering a more cohesive work-force.
Organisational Behaviour P.96
Recruitment, retention and training of appropriately skilled staff and in particular professionals from BME communities are workforce challenges currently reflected in the wider community. For example, the Audit Commission’s review of the sector; Changing Habits (2002) states that workers in the sector experiencing problems with delivery of treatment may be doing so as a consequence of “low levels of staff training and expertise…as staff in the sector are drawn from a wide variety of professional backgrounds”. Whilst this report acknowledges it is still early day in the life of the HMPS drugs strategy more can be achieved by utilising examples of best practice as they exist within the wider community i.e. Nafas, the Federation, The Blenheim Project etc. These can be adapted and tailored to suit the changing needs of the prison environment. Thus, supporting HMP Wormwood Scrub’s aim to provide more equitable service provision in relation to drugs treatment and intervention for those from BME and marginalised communities.
Recommendations________________________________________________ 1 1.1 Wandsworth Drugs Strategy Group Issues pertaining to Diversity and BME inmates within Drug Strategy Meetings are often seen as confusing to discuss due to a lack of knowledge of just how the areas play a role. This is especially so if the attendees are themselves unrepresentative of the prison population. As a result Diversity and BME inmates, if agenda items, usually translate into a brief look at statistical data coupled with the statement, “our services are open to everyone”, meanwhile gaps and service provision related shortfalls go unnoticed. There needs to be a mainstreaming of the Diversity agenda within Drug Strategy meetings as a standing agenda item or within service updates to be evidenced within minutes. However, before this can occur in a meaningful way consultation needs to occur with those involved in drug strategy to assist them in a better understanding of what to look for and options for change. Within Drug Strategy Meetings services need to address the question: “How might services evolve in order to meet the needs of BME inmates, Crack users and poly-drug users utilising independent consultants who have expertise in this area to assist the process wherever necessary. The Diversity Officer receives data from all areas of the prison except data related to drugs intervention. Although to date it has not been standard practice to do so, the Diversity Officer should to be supplied with full drug related data especially because, as stated by the S.O. of Drug Strategy, “The DSG at Wandsworth fully supports all issues of Diversity, Race Relations and Equal Opportunities”17. Perhaps the most important reason is in order to bring together the areas of Drug strategy/intervention and diversity/BME inmates. Prison Officers in general should be offered training in drug related issues and recovery in order for them to work alongside and as part of the prison drug strategy There needs to be a review of the prison induction process in relation to the giving of drug related information on services and motivating inmates to seek assistance or at the very least to declare their drug use18. Leaflets in a variety of languages on available services need to be made available at induction. Measures need to put in place to transform the VTU into a genuine drug free wing with full access to a range of aftercare intervention.
see appendix 0.09 see appendix 0.08
Substance Misuse Throughcare Co-ordinator The SMTCO can be a useful resource in identifying numbers of BME inmates not accessing services. Data should be compiled from inmate applications in regard to drug used, ethnicity and whether or not they are/have been in contact with services in the prison. This would also give a better idea in regard to the issue of drug users slipping through the reception stage without staff identifying that they are drug users. The role of SMTCO would make an effective addition to provision in other prisons such as Wormwood Scrubs. CARAT Service HMP Wandsworth Home Office guidance, the Development and Practice Report, states that, “Further developments in CARAT teams should concentrate on (1) increasing the number of places on therapeutic programmes and (2) prerelease planning to address employment and housing needs, and to establish ongoing contact with services outside prison”. p.6. a) Instead of or alongside the 1 wk crack awareness group there needs to be a rolling, intensive training/support group that targets (but not exclusively) those on remand or short sentences. These programmes need to be deeper than simply cognitive behavioural and broader than a focus on ‘the drug’ enabling participants to explore who they are. Such groups need to be facilitated by experienced, credible and confident workers. Extensive focus on longer term inmates occurs to the detriment of Shortterm/remand inmates a, who arere all too often excluded from provision. An alternative would be to put in place group-work that is specific to the needs of those who will very soon be out in the community. The Drugs and Prisons Report by The Select Committee on Home Affairs stated back in 2000: 59 “Drug treatment in prisons has focused on longer-term prisoners. The same attention needs to be paid to remand and short-term prisoners. They are more likely to be in prison for drug-motivated crime and treatment is more urgent because they will be released sooner. They are the greatest challenge if the cycle of addiction, crime and imprisonment are to be broken. We recommend that the Prison Service should make more drug rehabilitation programmes available to remand and short-term prisoners beyond what is currently envisaged under the CARAT service.” b) Offending behaviour groups should be provided or at least the inclusion of this subject within the above groups. c) 33% of those seen in December 2003 had no fixed abode and this is said to be approximately representative of month-by-month figures. As a result
it is essential that through-care/pre-release planning is reviewed in order to put forward a more realistic view of what can be done for inmates. Also, contract services need to be better informed of what community based services are currently available and ensure that time is allocated to assisting inmates with planning for their release. 3.2 Access to structured counselling is an important aspect of treatment19 for drug users and those seeking to maintain abstinence. Although this takes place for those on the RAPt programme there appears to be little in the way of structured one to ones for inmates with no experience of RAPt. Culturally appropriate talk therapy needs to occur to further enhance intervention in the prison. CARAT recruitment and retention policies need to be reviewed to ensure recruitment process and procedures for CARAT’s are designed to appeal to a wider audience and therefore are able to successfully attract professionals from BME communities. The NTA states that: “There is clear evidence that issues of anti-discriminatory practice in employment and issues of equity in service provision for diverse communities are, and should be considered as, related and not as separate issues”. p.7 Training needs to occur for CARAT staff on Diversity and working with diverse groups (Intercultural Therapy). Group-work skills training is also required. The Federation should support HMP Wandsworth to develop specific means by which the needs of BME inmates can be adequately explored in terms of the manner in which services are delivered. According to a questionnaire conducted within the prison with 10% of BME inmates20 there is some work to be done in relation to raising awareness amongst BME inmates of the CARAT team. Also, work needs to be done in order to change BME inmate perception of the CARAT team. 4. 4.1 RAPt – HMP Wandsworth An unannounced inspection of the prison that took place in January 2003 stated that the marketing of the RAPt programme needed to be looked at due to a lack of referrals onto the Primary programme. This situation has improved somewhat but inmates state that the programme is not as well known as it could be. It was stated by the SMTCO that RAPt Graduates
NTA –Models of Care see Appendix 0.08
are the best advert for the programme and that these graduates should facilitate informal groups that focus on answering questions that inmates may have regarding the programme. This idea would be perhaps the most effective way of raising awareness of the RAPt programme. 4.2 RAPt recruitment and retention policies need to be reviewed to ensure recruitment process and procedures for staff are designed to appeal to a wider audience and therefore are able to successfully attract professionals from BME communities. The NTA states that: “There is clear evidence that issues of anti-discriminatory practice in employment and issues of equity in service provision for diverse communities are, and should be considered as, related and not as separate issues”. p.7 5. 5.1 Healthcare – Substance Misuse Team The DDA was informed that there are plans to set up E wing as a post detox unit with a dedicated group room. However BME inmate access to in/out-patient detox is very small and those who use crack only do not generally enter the in-patient facility. As a result it is highly possible that there will be very small numbers of post-detox BME inmates moved to E wing. Any moves to develop the above facility need to be backed by a full impact assessment. There needs to be work done on exploring the various ways through which inmates can slip through the reception/induction phase without declaring or testing positive for drug use. Included in this would be identifying strategies to fill in the gaps. For example, a drug user may have been in prison in the past so has some experience. He may not have used his drug of choice within the last 2 weeks so his test comes up negative…. This inmate may still use while in prison. Race Relations and Diversity The lack of drug related information in a variety of languages has been an ongoing issue within the field in general. There is some confusion regarding feedback on Diversity training. The Drug Strategy Group sees it as “effective in reaching its aims”, while individually most of those on the group give opposite feedback. The Diversity Officer needs to receive full statistical data on drug related activity in order to be fully informed about the prison as a whole. As well as this, The Diversity Officer’s input on Drug Strategy meetings is vital in
6. 6.1 6.2
order for the Officer an others to become better acquainted with drugs and diversity crossover issues. 6.4 Diversity training needs to be properly evaluated with opportunities to discuss issues after the training so that concerns are not left to fester. Good practice would be to hold one or two open groups at monthly intervals after such training. Workforce Planning Carry out Equality Health Check to consider implications for Prison Service, BME professionals and Communities. Work with the Federation to develop diversity strategy; which defines what diversity means for the prison service (particularly in relation to race – common understanding that is flexible enough to accommodate the providers varying ways of working with BME inmates). Work with Federation to develop Diversity Manual – ‘Identity & Difference’ for bespoke diversity training programme for service staff and providers. Provision of leadership and management training for service staff and providers working with BME communities. Workforce & Cultural Competence There is a need for experienced drug workers who have the ability to effectively engage and relate with inmates at the reception stage allowing inmates to familiarise themselves with providers and to become motivated to seek further assistance. This earlier contact with drug services will aim to lower the number of drug users, in particular crack users, refusing to see the CARAT team. There is a need for crack specific workers – 49% of reception tests are positive for crack. Crack users also benefit from structured talk therapy and groups – this is a gap that needs to be filled if the Prison is to make significant progress in preparing inmates for life outside. Services as a whole would benefit from a survey as well as ongoing feedback groups into what inmates want from a drug service and their perceptions of current services. As well as informing the evolution of provision this would include inmates in the change process. The Audit Commission states that: “Without knowing anything about the people who use your service, how can you begin to understand their needs? Without hearing what they want from
7. 7.1 7.2
you, how can you focus on the areas that really matter to them? Without an accurate picture of their experiences, how can you be sure that you fully understand what works and what needs fixing, especially where your contribution is part of an extended process involving other agencies as well as your own?” p.64 8.4 The Drug Strategy needs to, as part of its vision, map out what constitutes a service matrix that will ensure the most effective treatment provision. This could be drawn up on the back of consultation with inmates and with assistance from specialists in the drug treatment field. Drugs related information (Harm Reduction, Information on dangers associated with various drugs, changing from one drug to another to try and avoid MDT positive results, etc.) in various languages would be beneficial for those at reception and within services on the wings. Other Services The Federation, Blenheim project or other organisation with a track record of running crack groups for BME communities needs to be approached with the view to developing a programme as part of service provision open to those on short and longer sentences as well as on remand. There needs to be stronger evidence gathered for BME take up of groups and evidence of the effectiveness of such groups. Consultation should take place across the board in order to develop a culturally sensitive model of working suited to the prison. Security The balance between security, supply and the availability of treatment needs to be explored. There is also evidence that due to MDT’s some inmates switch from cannabis to heroin
References & Literature Review
NTA for Substance Misuse - RRAA 2000 – Implementing good practice Home Office - development and practice Report – ‘The Substance misuse treatment needs of minority prisoner groups: Women, young offenders and ethnic minorities’ (2003) DOH - ‘Drug Misuse and Dependence – Guidelines on Clinical Management’ (1999) Audit Commission – ‘Change Here!’ (2001) Select Committee on Home Affairs Second Special Report - ‘Drugs and Prisons’ (2000) http://www.publication The McPherson Report Belbin – ‘Organisational Behaviour’ p.96 (1981) HM Inspectorate of Prisons – ‘an unannounced inspection of HMP Wandsworth (Jan.2003
1) Home Office – ‘Findings 186. Prisoners’ drug use and treatment: seven studies’ 2) Home Office – ‘Prison Population Brief’ 3) Home Office online report 33/03 – ‘Differential substance misuse treatment needs of women, ethnic minorities and young offenders in prison: prevalence of substance misuse and treatment needs’. 4) Home Office DSD – Updated Drug Strategy 2002 5) Home Office – ‘Tackling Crack – A National Plan’ 6) NTA/COCA – ‘Treating crack and cocaine misuse - A resource pack for treatment providers’ 7) NTA – ‘Models of Care’. 8) CRE – ‘Race equality in prisons’ (2003). 9) CRE – ‘The duty to promote race equality. Performance guidelines 10) CRE – ‘Public procurement and race equality’. 11) CRE/HM Prison Service – ‘Implementing Race Equality in Prisons’. 12) HM Prison Service performance rating system. 2nd Quarter 2003/04. http://www.hmprisonservice.gov.uk/corporate/dynpage.asp?Page=950 13) a. Prison Drug Strategy – detailed initial impact assessment (CARATs). b. Prison Service impact assessment (Reception). http://www.hmprisonservice.gov.uk/life/dynpage.asp?Page=807 14) Sangster D, Shiner M, Patel K and Sheikh N (2002) – ‘National Scoping Study’ 15) Audit Commission – ‘Changing Habits’
Appendix 0.01 The Federation Abd Al-Rahman – Diversity & Drugs Adviser (London Prison Service) Work Program (21st October 03 – March 04) Key: Area Drugs Coordinator (ADC) Chief Executive Officer (CEO), Head of Consultancy (HC), Drugs & Diversity Advisor (DDA), National Training Officer (NTO).
Target Date 28th November 03 .
Comment Essential requirement
Identify Mentor/Coach for external support and supervision (1) Support/advise steering group in relation to issues pertaining to diversity and drugs in prisons
Organise, coordinate and minute meetings, disseminate information
• Produce quarterly reports (December, March) ) Review all existing area and DSU data collection on BME use of prison drugs services • Review transcripts of Focus groups and produce report of key findings Review findings and responses to Action Research questionnaire. Visit HMPS London Area Office and access intranet (1 full day). Highlight any indicated service shortfall or trends. Report findings (plus Focus groups, Action Research) to ADC, Steering Group, FSC, FCEO
TBA – after second meeting with Huseyin
DDA/Prison Service (PA)
17th Dec 03 and 29th March 04
31st Oct. 03 DDA/HC 31 Oct. 03 DDA/HC Week commencing 3rd Nov.03 31st October 2003/ongoing DDA
(3) Evaluate Training needs and develop training pack for service employed staff • Develop, disseminate, evaluate training needs questionnaire. January 2004 February
questionnaire. • Make recommendations to steering group
February February 2004
DDA, HC, NTO DDA, CEO, HC
(4) Review and evaluate service diversity training for service employed staff
Organise Federation Diversity Training Session “Identity & Difference” for prison drug service staff Disseminate Evaluation forms, collate and feedback Make recommendations for further training.
February 2004 February/March 2004
DDA, HC DDA, CEO, HC
(5) Offer the contract drug services consultation and support their training needs and operational considerations to assist complying with the prison service duties and policies on diversity
Produce and distribute letter of introduction to Service Managers of contract agencies (1) explaining context of prison service work, rationale and (2) offering Federation consultancy services Visit 6 named establishments on at least two occasions each. Make recommendations on any necessary systems improvements. Highlight any indicated service shortfall or trends to be reviewed by steering group Follow up letter to Chief Executives of contract agencies in conjunction with ADC to arrange meetings with Contractors CEO’s & CEO, HC following completion of the Equality Health Check Process
7th November 2003
DDA, CEO, HC
by 9th January 2003 19th January 2004
DDA CEO, HC, DDA
15th January 2004
DDA, CEO, HC
Inform development of audit tool to establish awareness and practice pertaining to prison service duties and diversity
DDA, CEO, HC
Notes – Abd Al-Rahman, as discussed - fortnightly supervision is an essential criteria as well as your identifying an appropriate individual to provide you with professional mentoring and coaching
I am writing to inform you of work that is taking place within the London Area prison service in relation to drug strategy/intervention and BME inmates. The Prison Service London Area Office has funded The Federation of Black and Asian Drug and Alcohol Professionals for the post of Drugs and Diversity Adviser. The Federation is a national organisation established to support the needs of Black and Minority Ethnic (BME) professionals in the drugs, alcohol and related sectors, and their communities. The Federation acts in a consultant advisory capacity to central government; Drug Strategy Directorate (DSD) Drugs Prevention Advisory Service (DPAS), National Treatment Agency (NTA) etc. Informing the updated, National Drug Strategy, from a culturally sensitive standpoint. The role of Drugs and Diversity Adviser entails the following: 1. Support and advise the Area Drugs Co-ordinator, the Federation and the HMPS (London Area) Diversity steering group in relation to issues pertaining to diversity and drugs within the London area prisons. Review Area and DSU data collection on BME use of drugs services. Review and evaluate diversity training for service-employed staff. Evaluate Training needs and develop training pack for service employed staff Offer contract drug services within the London area prisons, consultation and support with their training needs and operational considerations to assist compliance with prison service duties, race equality and diversity policies
2. 3. 4. 5.
In order to carry out these responsibilities I have been visiting HMP’s Wormwood Scrubs, Wandsworth, Latchmere House, Pentonville, Brixton and Feltham to meet with service providers and others to gain insight into what services are available, to what extent BME inmates access them and how these services work with these inmates. The task is one that aims to advise and assist services wherever necessary in order to further enhance the quality of practice. I have already attended introduce myself to between the after which I had a chance to briefly . I am now booked to attend various meetings at .
If you require any further information regarding this work please call me at The Federation.
Abd Al-Rahman Drugs and Diversity Adviser
The letter overleaf was sent to the following Area Managers/Directors of Drug services within London area prisons HMP Brixton Adrian Davies Area Manager CRI 1st Floor Lorenzo Street Kings Cross London WC1X 9DJ CARATs Brixton and Wormwood Scrubs Peter O’Loughlin Area Manager Cranstoun Drug Services 112 – 134 Broadway House The Broadway Wimbledon SW19 1RL ______________________________________________________________________ HMP Feltham/Latchmere house (South Staffordshire – CARATs) Alistair Sutherland Director of Inclusion, Drug and Alcohol Services 20 Mill Lane Yately Hants GU 46 7TN firstname.lastname@example.org ______________________________________________________________________ HMP Wandsworth Joe Bernadello Director of Operations South RAPt Riverside House 27 – 29 Vauxhall Grove London SW8 1SY 0207 582 4677 0207 820 3716 fax email@example.com
www.rapt.org.uk CARAT Peter O’Loughlin Cranstoun Drug Services 112 – 134 Broadway House The Broadway Wimbledon SW19 1RL ______________________________________________________________________ HMP Wormwood Scrubs Andy Hillas Area Manager Turning Point 100 Christian Street London E1 1RS 0207 265 2010 firstname.lastname@example.org HMP Pentonville Andy Hillas Area Manager Turning Point 100 Christian Street London E1 1RS 0207 265 2010 Andrew.email@example.com
Linda Grice Joellen Reeves Remon James Taylor Nicky Francis Claudia Harding
CARAT Team Leader Cranstoun CARAT Admin CARAT Worker P.O. Drug Strategy Coordinator. Diversity Officer RAPt Acting Service Manager 1 x RAPt Senior Counsellor
8th December 8th December 8stDecember 9th December 9th December 11th December
Senior Substance Misuse Nurse 1 x Substance Misuse Nurse
12th December 12th December 12th December
Substance Misuse Throughcare Coordinator (SMTCO) 4 x inmates
Questions asked during meetings The following questions acted as a guideline and directional prompt. They were asked within the framework of a semi-structured discussion. Questions asked were based on relevancy to the staff member and their role.
• • • • • What is the nature of the drug treatment offered? (Detox, groups, one-to-one’s, models used, etc.) Is there Information in various languages? What is the ethnic breakdown of those referred? Are there mechanisms for inmate feedback? What are the drug related outcome targets? What are the output targets? How are inmates assisted at the prison exit stage? (links with outside agencies, etc). What has been done previously to address any BME unmet needs? Treatment service policies – On Diversity and Eq. Opps. How are they made live? Can you outline staff training in relation to Diversity? Do services feel that provision is sensitive to cultural differences? Do services feel that they meet BME inmate diverse needs? If so, how? How do they assess how well they are doing in relation to the above? How does the Race/Diversity agenda play a role in the Drug Strategy Group? Does a Race Relations Officer/Diversity lead attend Drug Strategy meetings?
• • • • • • • •
Inmate perspectives Discussion was held with 3 inmates from the RAPt programme within a group setting and an additional inmate who had completed the programme some time prior to the visit. After explaining why the DDA was at the prison one inmate stated that as much information as possible should be collected regarding the RAPt programme because, “it should be the benchmark for treatment services”. Another said that the programme has been great because there is plenty of help on the wing. The rest of the prison was said to be a joke – he couldn’t go to church, education programmes took two months and the attitude of staff were mentioned. Also stated was that RAPt is good and works for those who want it to work. In prison there is not enough emphasis on it because many are crying out for help but can’t get it. “There are about 1500 inmates but RAPt has 16 beds. There’s not enough on offer. Not enough people know about RAPt.” The SMTCO was said to be “the backbone of treatment services”. Added to this was that, “If you want the tide to turn more need the course. If more RAPt grads are on the wings this would be productive.” “The VTU is there to make the prison look good but its not running like a VTU.” An inmate said that MDT numbers are being bumped up by testing those on the RAPt programme who are known to be drug free. The general prison regime was said to be “incompetent” – “how can they not see what is wrong? The excuse is always lack of staff.” Aftercare was said to be the weak part of the process because back on the wings or even the VTU there are lots of drug users and others who have been through the change process. “No matter where you go outside in wings it will be deficient. Everyone is flowing the same in RAPt.” (i.e. everyone has a shared understanding) One inmate said that he originally got onto the programme because he wanted parole and thought it would be a “soft touch”. However, when he started the programme he was challenged by other inmates within groups and this made him begin to look hard at himself. Another inmate, who said he was now writing a book, said that “by doing the course my son has benefited because I’ve changed so much, I thought I
had burnt my bridges with my family but not only have I got off drugs, I’ve also got know myself. Every second of the day is important”. One inmate said that he was 45 years old and has been clean for 7 months now and this was like a miracle. It was said that the self-change could really be noticed when with others who have not changed. “The main thing about RAPt is that I was in denial before but the programme allowed me to own and take responsibility for my own actions.” “The programme taught me how to work things out in a way that is different from how I was before.” The DDA was informed that heroin was the drug of choice in the prison due to its effects and due to MDT’s. Many inmates in the general prison population are leaving Wandsworth with a ‘taste’ for heroin. All inmates felt that the programme is best at the beginning of a sentence rather than near the end because afterwards more time can be utilised to solidify changes.
2 2.1 2.2
Staff perspectives In order to mask identity everyone quoted below is referred to as ‘a member of staff’. The following came out within meetings. A member of staff stated that the Voluntary Testing Unit - VTU has “gone to pieces due to lack of staff.” It was also stated that if no staff are present to conduct tests then what you have in the VTU is simply “a name on a board”. It was also stated that treatment programmes are irrelevant if drugs are so prevalent within the prison. Added to this it was said that there was no safe place after programmes and drug dealers do what they can to get onto the VTU – “They are as organised in prison as in the street.” With reference to the level of availability of drugs it was stated that “people who work in the prison in general as well as officers” bring them into the establishment. It was stated that if measures were put in place to cut down availability by 60% - 70% the prison would be unstable leading to fights. Most fights were said to be drug related. A member of staff stated that courses are great but if security is weak then what’s the point in having services. One member of staff had not been on Diversity training in 7 years of working in prisons. It was said that people accessing such training get angry about the way it is facilitated and feel that it is part of a wider “witch-hunt.” It was said that many crack users are African Caribbean and this is more to do with fashion. This group sees heroin seen as “a dirty thing”, particularly injecting. It was also said that inmates see ‘lines’ as better than ‘piping’. “The environment in prison is slow to change making many staff cynical and deluded” – A member of staff. “In Diversity training things were said that if people of a particular culture were present they may have been offended” – A member of staff. ”If it exists Diversity training is ineffective” – A member of staff who has worked in prisons for 8 years. It was stated that C and D wings are the worst for drug availability/usage.
2.9 2.10 2.11 2.12
General observations There is a disjointed approach to dealing with inmates between the various health/treatment focused staff and many prison officers. Some officers do not demonstrate an understanding of the need for intervention that seeks to rehabilitate inmates and this, at times, impacts upon the relationship between Officers and treatment staff. There is a perception that to look at BME specific issues is in some way discriminatory, especially as drugs themselves do not discriminate. As a result, diversity issues are masked behind the phrase “our service is open to all”. Innovation within drug services is stifled in Wormwood Scrubs. There was no evidence of innovative ways of working born out of consultation between services and with inmates. Innovation is all the more necessary when one considers, for example, that Crack users make-up a substantial number of drug users in the prison. There is no data found regarding completion/retention in treatment by ethnic group.
Aware of CARAT service? Yes no Never heard of them Unknown Total
31 17 8 1 57
Satisfied with CARAT Very Useful Useful Satisfactory Useless Unknown Total
5 7 4 4 37 57
Drug User? Yes no Unknown
20 24 13 57
Used Drugs in the past Yes no No response Total
34 19 4 57
Want access to Drug Treatment? Yes No No Response Total
24 29 4 57
Meet Treatment cultural & religious needs? Yes no Satisfactory No response Total
3 9 10 35 57
Want treatment on release? Yes no No response Total
19 20 18 57
On Remand? Yes No No Response Total
15 36 6 57
Waiting to see CARAT worker 0-2 weeks 2-4 weeks 1-3 months 3 months + Total
7 5 3 0 15
Questions emailed to the P.O. of Drug Strategy 1. Does the RRLO attend Drug Strategy Meetings? If not do they receive, as standard practice, drug related figures? 2. Who sits on DSM? 3. How well do you feel drug services work with BME inmates? 4. Have any shortfall areas been identified in the past? If so what was done to tackle this? 5. What part does the issue of diversity play in DSM’s? 6. Have you been on Diversity training? If so, how effective is it in reaching its aims? 7. What are its aims? Reply 27th January 2004 Dear Abd, You e-mailed Jim Taylor last week and he has asked me to answer some questions that you sent him. 1. You asked if RRLO attended our monthly meetings. She has not in the past but will be invited in the future. It has not been standard practice for her to receive drug related figures. 2. Carats, RAPt, SMTCO, Security, B-wing (VTU), Dog Section, Detox (Healthcare), Visitors Centre, attend drug strategy meetings. 3. WE are in the process of issuing a Needs Analysis to prisoners on induction and reception. 4. No shortfalls have been identified in the meetings regarding BME. 5. The DSG at Wandsworth fully supports all issues of Diversity, Race Relations and Equal Opportunities. 6. Most staff on the DSG has been on Diversity training and is very effective in reaching its aims. If you would like to e-mail me your postal address then I will be able to send you the further information you require regarding Carat services for a 3 month period and the prison population and ethnic break down. Regards Senior Officer Kev Gwyther Drug Strategy Unit.
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