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Treatment systems; Safeguarding the community

Key studies relating to local, regional and national systems for effectively and cost-effectively providing treatment in criminal justice settings and/or to safeguard the community.

S Seminal studiesK Key studiesR ReviewsG Guidancemore Search for more studies

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K Probation struggling to cope with alcohol-misusing offenders ([UK] Ministry of Justice, 2009). National study in England and Wales describes a system creatively grappling with a huge drink problem among offenders, but undermined by lack of evidence and under-resourcing linked to a dispute over whether health or probation should be the core funders. See also similar report for Scotland (NHS Health Scotland, 2011). Discussion in bite’s Highlighted study and Issues sections.

K “Unmet need” for alcohol services in Britain’s prisons (HM Inspectorate of Prisons, 2010). Inspections and surveys of prisoners and staff in England reveal “very limited” services for problem-drinking inmates, leaving them with poor prospects on release. See also similar report for Scotland (NHS Health Scotland, 2011). Discussion in bite’s Issues section.

K Challenges to collaboration between health and criminal justice (2010). Based on exhaustive consultations in south west England, investigates the blockages to providing alcohol-related services to offenders and recommends improvements in commissioning, coordination and practice. See also associated policy report (2011). Discussion in bite’s Issues section.

K Systemic barriers to employing problem drinkers ([UK] Department for Work and Pensions, 2010). Clearest lesson from interviews with alcohol service clients in Britain and with staff working in or with treatment agencies is that interagency working can result in better support for problem drinkers and better access to training and employment opportunities.

K Inter-service networking associated with evidence-based treatment (2008). Rather than commission a single large organisation, suggests that to improve uptake of evidence-based practices and quality improvements commissioners should promote networking between several agencies providing treatment for substance users in the criminal justice system. Discussion in cell D5’s bite.

K Lessons from Welsh pilot of integrated support for children affected by substance use in the family (Welsh Government, 2014). Evaluation of the first three local schemes in a nationwide rollout of services based on the Option 2 crisis intervention service for families of parents with drug or alcohol problems. Documents how the schemes changed in response to experience and strategic and operational contexts.

K G Uncovering and responding to children’s needs in relation to problem-drinking parents ([English] Office of the Children’s Commissioner, 2014). On the basis of investigation of case study areas, aimed to identify and promote good practice. Key questions were how local areas can discover the extent of need and how services can best respond. Discussion in bite’s Issues section.

K Treatment alone did not cut drink-drive deaths (2005). Multi-million dollar attempt to equip US communities to tackle substance misuse only succeeded in reducing alcohol-related traffic deaths when treatment initiatives were supplemented by measures to limit the availability of alcohol.

R Managing drink-drivers (Health Canada, 2004). Canadian report based on reviewing evidence and expert opinion; includes recommended ways of coordinating treatment, rehabilitation and enforcement approaches to alcohol/drug impaired driving.

R Melding disparate objectives and cultures is key to criminal justice treatment (Australian Government, 2005). Realistically acknowledges (section headed “Providing AOD treatment within the context of the criminal justice system”) that criminal justice and treatment have different objectives and philosophies and don’t naturally see eye to eye, but argues that education and training can underpin collaboration to achieve shared goals. Discussion in bite’s Where should I start? and Issues sections (Does Britain have the right partnership ingredients?; How far should collaboration go?).

R Non-coerced treatment associated with greatest crime reductions (2008). Synthesis of 129 studies of offender treatment for problems including substance use finds treatment’s crime-reducing impact increased to the degree to which the offender was free to choose treatment. Implication is that treatment systems should make it easy and attractive for problem drug users to enter treatment without legal coercion.

G Management of problem drinking offenders in England and Wales ([UK] National Offender Management Service, 2010). Official guidance on the commissioning, management and delivery of interventions for alcohol misusing offenders; predates changes in targets and performance indicators and commissioning and service provision structures introduced since May 2010. See also general health commissioning guidance ([UK] NHS Commissioning Board, 2013) issued after NHS England took responsibility for commissioning prison healthcare and local authorities for commissioning public health services for offenders under community supervision, in both cases including treatment of substance use problems.

G Alcohol and offenders guidance for Scotland (Scottish Government, 2012). Guidance and support for commissioners and planners who have a responsibility for developing strategic responses to alcohol problems among offenders.

G ‘Whole-family’ recovery advocated in Scotland (Scottish Government, 2013). Guidance specific to substance use intended for all child and adult services, including drug and alcohol services. What new patients should be asked about children and the role these services should play in a system which (“Getting our Priorities Right” is the title) prioritises child welfare. Discussion in bite’s Issues section.

G Protocol for joint working between drug/alcohol services and children/family services ([UK] National Treatment Agency for Substance Misuse, 2011). Intended to help local areas develop agreements to strengthen the relationship between these services in order to safeguard the children of substance users. Includes identification, assessment and referral, sharing information, and staff competencies and training. Discussion in bite’s Issues section.

G A model system for responding to problem-drinking prisoners (World Health Organization, 2012). Based on UK experience, offers an integrated model of best practice care for problem-drinking prisoners from screening through brief intervention and more intensive treatment, depending on need and feasibility.

G Working together to prevent domestic violence and abuse ([UK] National Institute for Health and Care Excellence, 2016). Planning and delivering multi-agency services for domestic violence and abuse.

G Lessons from drink-related domestic homicides (Alcohol Concern and Against Violence and Abuse, 2016). Messages for UK alcohol treatment services and their commissioners on preventing change-resistant drinkers from perpetrating domestic violence, abuse, and homicide, investigations of which informed the guidance. Discussion in bite’s Issues section.

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