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Screening for learning disabilities in prisons

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Screening for learning disabilities in prisons

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  1. Screening for learning disabilities in prisons Glynis Murphy, Tizard Centre, Kent Univ

  2. Offenders with LD: prevalence • Interpret data with care! • Samples vary, methods vary! • Eugenics era: assumed to be very high rates but little good data (eg assessed only those referred with problems; used incorrect norms) • In USA: early studies showed 10% of prisoners have ID; recent studies: 3% & less • In Australia: often get figures around 10% or more; higher in Aboriginal populations; affected by ethnicity? + lack of diversion possibilities?

  3. Offenders & ID: prevalence • In UK: studies in 1990s- police station: 5-9% acc to Gudjonsson et al - probation: 6% acc to Mason & Murphy 2002- prison: <1% - Harnett, Holland & Murphy, ‘95 • More recent UK studies suggested 7% of prisoners have learning disabilities – e.g. Mottram et al study in NW prisons – but methodology criticised • Do exact numbers matter?

  4. What prisons currently do • In the No One Knows Programme, Jenny Talbot (Prison Reform Trust) asked prisons whether they screen people for learning disabilities or difficulties • No routine screening going on at time (2008) • Clear from rest of ‘No One Knows’ that prisoners with LD were very disadvantaged in terms of: accessing visitors, doctor appoint-ments, ordering meals, accessing work training, + accessing treatment programmes.

  5. Bradley report • Amongst other recommendations, asserted that prisons should screen for LD • Clearly best to screen at entry to CJS – i.e. at police station – that is still (my) long term aim • Meanwhile let us try screening in prison! • Common objection: but what can we do if we find we have got prisoners with LD? • Our answer: all sorts of things! - AND if you don’t know who has LD, how can you help them at all?

  6. How can we screen? Common tools & requirements • WAIS-IV - gold standard IQ test; takes 45mins-1hr; done by psychologists only • WASI - short form IQ test; takes 20 mins; done by psychologists & a few others • HASI – much like the WASI; validated in CJS; can train few others to do; over-estimates IQ • LIPS – takes 15 mins; vocab & clock drawing; can train others to do it; validated in CJS • LDSQ – 10 mins max; very easy to train others; validated in community

  7. Dept of Health trial in 2010/11 • None of tests ideal (adaptive behaviour issue) • BUT: Used LDSQ to screen all new entrants to 3 prisons in a 3 mth trial • Durham, Birmingham, Wormwood Scrubs • Screening done by LD nurse in healthcare in Wormwood Scrubs; by DLO in Birmingham & by Education & Skills staff in Durham • Done in first 48 hrs in W. Scrubs + Bham but later in Durham • Overall positive ID for LD 7% - see next slide for exact numbers

  8. Dept of Health trial

  9. What happened next? • Up to each prison what they did when someone identified with LD • Wormwood Scrubs: the LD nurse called up their local CLDT & invited them in to meet the person & do a full assessment • Birmingham: 3rd sector agency Care First worked in prison (doing activities like crafts) & followed people up when they left – those with LD referred to them • Durham: ???

  10. What else would we like to do? • Train prison officers on what this means & what support the person may need • Ensure support for person on literacy - eg to fill in forms for visitors, meals, doctor visits etc • Ensure not bullied/harrassed/tricked • Ensure wing officers aware (eg he may be struggling to understand, not being stroppy) • Provide easy read info • Provide access to work + treatment • Ensure liaison with local services

  11. What happened after the DH 3 mth trial? • A hold up + Government change + austerity! • Is it still the right thing to do? • If yes, why arent we doing it? • Is it just resources? (who pays for LDSQ forms? Who conducts the assessments? Who logs the data? Where? Who follows up?) • Screening is a target for CLDTs & prisons......

  12. Conclusions • We know how to screen for LD • We could negotiate reasonable price with test company • We know how to liaise with prisons • We have some ideas for what to do after people are identified • We know its the right thing to do • Lets do it!