How the NHS can respond to the needs of prison leavers and families affected by imprisonment

1. How the NHS can respond to the needs of prison leavers and families affected by imprisonment Yvonne Dalziel Public Health Practitioner Edinburgh CHP Hello � this afternoon I want to outline the practical elements of the PATH prison leavers project and demonstrate how the NHS responded to the needs discovered � I am only going to show you 5 project today � these are initiatives that I have been involved in � there is much more but these were chosen as examples of what NHS can do This was development work and with development work some of it works some of it doesn�t � sometimes it depends on who you work with and what resources you can access I was delighted but not too surprised by the response I received from partner agencies � as a community development worker I find its not possible to work without partners � they want to get involved with health Hello � this afternoon I want to outline the practical elements of the PATH prison leavers project and demonstrate how the NHS responded to the needs discovered � I am only going to show you 5 project today � these are initiatives that I have been involved in � there is much more but these were chosen as examples of what NHS can do This was development work and with development work some of it works some of it doesn�t � sometimes it depends on who you work with and what resources you can access I was delighted but not too surprised by the response I received from partner agencies � as a community development worker I find its not possible to work without partners � they want to get involved with health

2. Background and Aims Project funded by MCNI Aim to explore health improvement needs of prison leavers and their families Identify factors involved in re-offending Develop partnerships to meet needs Funded for 18 months � just ending � what I was paid to do Funded for 18 months � just ending � what I was paid to do

3. Population groups Average daily prison population 2007/08 = 7376 Overwhelmingly from 15 SIMD 5% are women (2007/08 = 371) Families affected by imprisonment � 60,000 visits per year � HMP Edinburgh Children � 15,000 Male prison leavers � with a City of Edinburgh home address � 2007/08. Sentenced less 4 years � 576 adult male liberations Remand: 518 Female prison leavers � with a City of Edinburgh home address � 2007/08. Sentenced less than 4 years � 48 adult women liberations Remand � 65 women Male prison leavers � with a City of Edinburgh home address � 2007/08. Sentenced less 4 years � 576 adult male liberations Remand: 518 Female prison leavers � with a City of Edinburgh home address � 2007/08. Sentenced less than 4 years � 48 adult women liberations Remand � 65 women

4. Methods and theory framework Underlying theoretical framework Community development - engagement Social capital - networks/ social ties/ trust/ reciprocity Social determinants of health - Swedish Model WHO 2005 Attachment theory - Bowlby Methods Focus group Interviews How I work is important to me � I use a community development approach � and a belief that it is the social environment that produces the health status so that is where you need to start to make the changes I interviewed prisoner sin three prisons and ran focus groups How I work is important to me � I use a community development approach � and a belief that it is the social environment that produces the health status so that is where you need to start to make the changes I interviewed prisoner sin three prisons and ran focus groups

5. Needs of Prison Leavers Housing Financial Employment Support for drug and alcohol problems Family contact Mental health issues None of these needs will surprise you � what is not on that list is the need for increased confidence and resilience � all the prisoners had underlying alcohol and domestic violence issues � all the men in HMP Ed had come from backgrounds of alcohol � most of the boys and all of the women � have relationship and violence isues etc None of these needs will surprise you � what is not on that list is the need for increased confidence and resilience � all the prisoners had underlying alcohol and domestic violence issues � all the men in HMP Ed had come from backgrounds of alcohol � most of the boys and all of the women � have relationship and violence isues etc

6. Introduction to Market Place Visitor Centre Women Offenders Willow Project Work of the CJA Women Offenders Group West Craigie Farm Project Ithis presentation is really about the market place � which is happening upstairs after this presentation � its your opportunity to meet the workers who are involved in these initiatives and aks them questions � there are 5 Ithis presentation is really about the market place � which is happening upstairs after this presentation � its your opportunity to meet the workers who are involved in these initiatives and aks them questions � there are 5

7. Prison Visitor Centre Source of support for families - information and help - difficult to engage Family support worker established Play worker/ therapist post in planning Social tourism project - social capital Health and literacy - confidence building Support for first time visitors - peer support

8. NHS input Developing healthy caf� Cooking classes/ food tasting/ food co-op Credit union Support for domestic abuse Raising awareness � linking families into mainstream services Linking families into community health projects/ Keep Well

9. Willow Project Women needs differ men Project funded by addressing street prostitution fund SHPS Women Offenders Post Integrated services to support women in prostitution or at risk of Living skills/ therapeutic support/ employability/ relationship help/ fun Referrals from agencies/ Corntonvale etc

10. CJA Women Offenders Group Identify the most effective risk assessment tools and interventions for women offenders Develop Gender specific programmes Develop effective services for women offenders Develop programmes that address abusive relationships Training Principles for working with women

11. West Craigie Farm Farm project involving CS Orders and prison leavers Income generating Integrated service � health promotion/ employability/ developing range of skills/ confidence building / fun Funded by.�..

12. Partnerships for Access to Health (PATH) Project How to get in contactHow to get in contact