Hosted by the South West Reducing Reoffending Partnership, the multi-agency event explored ways to improve services for people re-entering the community after leaving prison, and help them to continue to access treatment in the community.
Around 150 attendees from organisations across the region gathered to hear speakers from the Department of Health and Social Care, local authorities, charities, HM Prison and Probation Service (HMPPS) and lived experience individuals discuss the issues faced in ensuring the right care is delivered when and where it is needed.
Kim Hager MBE, joint commissioning manager communities and public protection/public health for Cornwall Council, is the drugs strategy lead for Cornwall and the Isles of Scilly.
She spoke about the devastating impact adverse childhood trauma including abuse, neglect and alcohol and drug use can have, and the risks that can have of leading to experimenting with drugs and developing dependency into adulthood. She highlighted the difficulties in understanding the level of trauma an individual can be dealing with.
“It may take up to seven years, research says, for someone to volunteer the information about a single trauma,” she said. “They don't always recognize that that wasn't normal.”
Her team has made a number of changes to take a more trauma-informed approach, including a routine inquiry questionnaire, modified assessment and treatment tools, and a focus on the cementing the bond between worker and client to create trust and safety.
The importance of taking a gender-informed approach is also key, according to Christina Line of the Nelson Trust, a South West charity providing residential treatment and specialist women's central services.
She said: “One in three women experienced psychological abuse from a partner, one in five women have been raped, one in three women experienced abuse as children, two in five women experienced mental health challenges, 70% of women in the criminal justice system are in there for nonviolent offences, and 17,000 children are separated from their mothers. So if we're looking for causal factors in women's addictions, the adversities women face are a really good place to start.
“Sex and gender-based issues and requirements need to be considered in the design and delivery of substance misuse services to address the distinct needs of women, and that includes a safe space recognising their experiences of trauma and abuse.”
Chemsex – the use of drugs among men who have sex with men – is a key challenge in the criminal justice system, with more than 300 people in prisons specifically relating to crimes associated with chemsex, according to Ben Kay, an advanced practitioner focusing on equality, diversity and inclusion and LGBTQ+ substance misuse issues across Bournemouth, Christchurch and Poole.
He referenced research undertaken by Project Sagamore, which looked at chemsex and crimes relating to it, saying: “The findings totally undermine the comfortable story about it being a party drug and about it being fun, because the findings on violence are particularly hard hitting within the chemsex context. Other categories of offences are higher in the general prison population.
“Across Dorset many chemsex crimes are underreported or just simply not being recognised by frontline workers. Collaboratively, we can work together to best support the communities and work in partnership along with ourselves, criminal justice systems and the police forces to help break the barriers similarly to what's been done elsewhere in the country.”
Rob Fenwick, who runs the navigator complex needs service at Exeter City Council, spoke of the trauma-informed work his team is doing to help those leaving prisons with complex needs.
“Poverty, trauma and disadvantage are often locked together in a knot, which we are trying to untangle as we've worked with an individual,” he said.
“I rely upon and expect the staff in my team to be routinely challenging the system as it presents to the people that they're supporting, being interested in human beings and their stories without which the opportunities to build that trusting relationship are undermined.”
Richard Jones of Julian House, which runs prison resettlement projects across the South West, emphasised the profound consequences of drug use in prison leavers.
“The alternative for a lot of prisoners leaving prison is rough sleeping. That comes with an incredibly pronounced risk to life, not just quality of life, but absolute life. The life expectancy for a male rough sleeper is only 45 years, and for a female rough sleeper is only 43 years.
“We have seen a number of people within the last six months that haven't successfully completed that transition from the prison to the community and have sadly died in that window.”
The webinar also heard from Patrick Francis Cunningham, a former drug user and chair of Devon’s Narcotics Anonymous, who takes recovery meetings into prisons and mental health hospitals in Devon. He spoke of how important it is to get meetings to people who are not in a position to access them, and the challenges he has faced in getting into prisons to offer help.
And community offender manager Jennifer Dudman, of HM Prison and Probation Service, spoke about the importance of taking a holistic, multi-agency approach to people on probation with substance misuse, and sharing information among agencies in real time.
“For us it's all about the three Cs - communication, coworking and colocation and hopefully everything that we do then helps support them with continuity of care,” she said.
The importance of putting service users first and using the right language was highlighted by John Hamblin, CEO of Shekinah, a Plymouth-based regional homeless charity and member of the Plymouth Alliance which aims to support those with complex needs.
He said: “People say don't get hung up on words, but for people using services this is really important. Particularly in homeless services, we talk about frontline staff, entrenched rough sleepers, task force - that is all the language of conflict. We should not be using that language.
“If you break down what we do care, kindness, empathy, service duty, that's what we all do.”
Rural challenges were also discussed with key issues being lack of transport links to help users access services in the community.
Alison Hernandez, Police and Crime Commissioner for Devon, Cornwall and the Isles of Scilly, and chair of the South West Reducing Reoffending Partnership, thanked those taking part for their honesty and openness, adding: “Relationships are fundamental in how we work in the South West to reducing reoffending, partnership and working together, and it seems that it needs to be at every level.
“Because we don't get the level of funding sometimes the other regions may get we tend to have to work together to solve the problem with what we've got.
“We're really keen as a region to make sure we up our game about how we are utilizing people with lived experience to improve the system and support them to be able to help us improve the system.
“Let's help our users who, at the end of the day, want to not be addicted to substances, be able to live a substance free life.”