Commissioning us - Criminal Justice: Resettlement after leaving prison
How we can help
Since April 2011 we have worked in HMP Nottingham with Nottingham Healthcare NHS Trust to provide personalised resettlement support for offenders with an identified mental health need who are leaving prison after a sentence of less than a year. By providing a consistent source of support, which short term offenders with mental health needs currently lack, we improve offenders’ social and psychological outcomes as well as reduce reoffending rates.
This group of people “fall through the net” of statutory service because they do not qualify for support from the probation service and are not tracked through prison by mental health services. Once released from prison this group is very vulnerable to a further decline in their mental health and/or a high likelihood of reoffending.
What we do
The resettlement workers are supervised by the NHS outreach worker based in the prison (within existing NHS provision). Prisoners identified as having a mental health problem on reception to the prison are immediately linked with the resettlement workers. The team supports the person throughout their sentence, advocating (in a non technical sense) on their behalf in the community for the necessary support prior to release.
When the person is released one of the resettlement workers is at the gates to facilitate their reintegration into the community. They escort them to appointments with statutory services to embed them with existing support structures such as the GP, drug and alcohol teams, employment support and community mental health teams. The resettlement worker is specially trained to support people with mental health problems such as personality disorder, depression, anxiety, bi-polar disorder or schizophrenia.
We began working with Steve after a referral from Probation. Steve had severe anxiety and depression. Although he had been prescribed medication, was not taking this as prescribed. Steve was self-medicating with cannabis for his illness and poor sleep pattern. He also had difficulty controlling his temper, and found the slightest thing would make him ‘flip’.
We helped Steve to see his GP to be restarted on his medication and be seen by a mental health professional. He was restarted on medication and referred to the in-house Mental Health Nurse. We also discussed reducing the use of cannabis, explaining the benefits of doing so.
For the next few weeks we supported Steve with occupational and educational activities, benefit issues and maintaining a good relationship with probation.
Steve never received an appointment from the Mental Health Nurse, and his mental health began to suffer to the point when he stopped taking medication again. As a result, he reached crisis point, attempted suicide and became violent with his partner. We booked an emergency appointment with his GP, who in turn started him on new medication which would help with sleep, gained an appointment with the crisis team, and arranged to see him the following day. We supported Steve with this appointment, arranged for the Community Mental Health Team to assess him, and for a psychiatrist to see him.
Slowly, Steve has got his life back on track. He is still not 100%, but with two weekly visits from us he is now looking further afield and has a more positive outlook. We are supporting Steve look into college courses and ways of keeping healthy. He has restarted a hobby he enjoys, and is taking medication regularly. He no longer uses cannabis as he can now sleep without the need for this. He knows we will attend appointments if he requires support, and that we are only a phone call away should he have any concerns. We are helping Steve find counselling, which we hope will help with his past issues, and encourage him to control his temper. Steve is now back with his partner. He keeps to arranged visits with us and probation, and is slowly getting his life back on track. He has recently started paid work again, and is finding the structure to his day is helping.
We aim to work with around 750 offenders a year over the lifetime of the project. We are evaluating the service against our objectives which are to:
- Improve social outcomes such as secure housing, registering with the GP, employment, education and training opportunities.
- Improve mental health outcomes such as reduced incidence of crisis admission to hospital.
- Reduce reoffending rates.
- Create an evidence base of what works in resettlement support for offenders with mental health needs, including cost savings, which can be used to influence policy makers.
Nottingham Trent University is conducting research with prisoners at HMP Nottingham and have agreed to support us in this endeavour.
You may be interested in:
Criminal Justice: Court or pre-prison liaison and diversion
Criminal Justice: Talking therapies in prisons
Need practical advice & info? We can help.
Contact our Advice team about mental health & related issues
0300 5000 927 Monday - Friday 9.30am - 4pm, not including bank holidays