Women Defendants Appearing In Bristol Magistrates Court -A 4 month Pilot Study

1. Women Defendants Appearing In Bristol Magistrates Court -A 4 month Pilot Study Presented By Helen Bell (women's advocacy worker) Anita Gukhool (CARS Practitioner) Dr Sarah Hean (Bournemouth University)

2. CONTENT OF WORKSHOP • PERSPECTIVE 1: The Court Assessment & Referral Service (CARS) • PERSPECTIVE 2: Women’s Advocacy Worker • PERSEPCTIVE 3: Evaluation perspective • GROUP WORK ON HOW TO ADDRESS CHALLENGES AND BARRIERS • GROUP FEEDBACK

3. PERSPECTIVE 1: The Court Assessment & Referral Service (CARS)

4. The Court Assessment & Referral Service (CARS) • Operational May 2007 • Avon & Wiltshire Partnership Trust Band 7 Team Leader Band 6 CARS Practitioners (x2) Band 6 Learning Disability Specialist Practitioner Band 4 Housing Link worker Band 4 administrator • Mental Health Assessment and Liaison service Identifying appropriate care pathways. • Timely Information to Sentencers (same/next working day) • South West Court Pilot- providing information to sentencers via screening reports/HSCR/psychiatric reports (including Bristol Crown Court and Bath Magistrates Court)

5. Identifying Women's Needs • Pro-active screening in Custody Cells (MHIS) • In 4 month period in 2008 (Pre Women's advocacy Worker) 1087 people in custody MHIS checked:- 171 Total assessments offered by CARS (men/women) 30 were women (141 men) 10 out of 30 women declined MH assessment 19 out of 141 men declined assessment • Standard assessment document used by CARS for men and women (No specific childcare/family/training and education focus) • Majority of women seen by CARS are already known to mental health services

6. CARS – Engagement with Women Defendants • Only 12.5% of defendants seen by CARS were women. • Approx 7:10 women identified to CARS by MHIS declined to be seen • Approx 1:10 men identified to CARS by MHIS declined to be seen • No data around reasons for declining collected by CARS Practitioners

7. Challenges and barriers • Women declined almost 3 times more than men to engage in mental health assessment at court. • CARS are a mental health statutory service • No proactive screening of Bailed defendants • Women identified in Custody have often presented with a primary substance misuse issue and feel their needs are already being met by Substance misuse services OR that their offences have triggered a statutory referral to CJIT (Drug and alcohol assessment -which takes place on the morning of court in custody cells) • CARS practitioners do not hold case loads and therefore work outside of court is not possible and direct follow up work with the individual is limited. • CARS provide information directly to the court – this can be a barrier to women engaging with the service

8. Challenges and Barriers (cont.) • Solicitors keen to have cases heard in court at earliest opportunity and unless they believe there to be an OVERT mental health problem which would directly impact on court outcome they are keen to advise not to engage with CARS • Environmental factors – noise/ heavily male populated cells can hinder assessment process • Primary role to identify appropriate mental health care pathways – often leaving little time for CARS Practitioners to explore very specific social needs ie housing/Benefits/training and education needs. • CARS interventions are specifically focused around those individuals with a mental health need • Mental Health practitioners have limited Knowledge of Benefits system/voluntary sector organisations (specifically for women) – information needs to be immediately available to defendants due to a number of factors chaotic lifestyle/no further contact with court etc • CARS referrals have not significantly changed since women's advocacy worker has been in post- however greater advice and liaison role- to support Women's Advocacy Worker to signpost women re: mental health.

9. PERSPECTIVE 2: Women’s Advocacy Worker

10. Anticipated Outcomes • Identify whether there is a need to employ a Women’s Advocacy Worker within the CARS team in Bristol Magistrates court. • Identify the data collection required in order to record the needs of women offenders within Bristol Magistrates court. • Map the services available to women within the Bristol area. To collect information/data re: • The referral of women defendants to CARS • The referral of women defendants to community services Would this increase number of women accessing appropriate mental health services? Would this increase number of women accessing appropriate support and advice in the community? • Improved knowledge of the local community based support available for women. • Improved knowledge and awareness of the needs of women in the criminal justice system.

11. Role of Project Worker • To speak with all women defendants in Bristol Magistrates court in order to identify their needs. • To gather information about existing, local community services which are available to women • To link women appearing in Bristol Magistrates Court with appropriate provision in the community. • To identify any gaps in service provision to meet the needs expressed by the women. • To collect and record data on all the above.

12. Identification of Women In Court • An Average of 15 Women in Bristol MC daily • 3 full assessments able to be completed daily • Referral Sources: - reliance- Custody cell security staff - solicitors - CARS • Pro-active Identification - Custody and Bail Court Listing • Identifying fines and breeches courts at an early stage

13. Women's Experiences • 86 Women were seen (149 Sessions in total) • 11 Declined to engage • Common Themes linked with those discussed in Corston Report: • Childhood sexual abuse • Local Authority Care • Domestic violence • Substance misuse • Relationship issues (inc cohesive relationships)

14. Model/Approach Used • Women in custody prioritised for duration of Pilot • Informal approach- NOT linked to statutory services/or court process (independent of CARS) • Everything Based on Self-Disclosure -Own consent form- Offering choices and empowerment. Remain accountable to child protection/vulnerable adult procedures etc. • Areas explored with women: Accommodation, Financial matters , Family/Relationships, Employment/Education, Risk (inc Domestic Abuse/Substance Misuse), Physical/Mental health/Disability, Existing support networks and Meaningful activity. Equal opportunity monitoring. • Documents – devising specific assessment Document for use with women • Referring and sign posting to services to help meet or further assess needs

15. Challenges and Barriers • Time limited: Cases listed for 9:30 – women need to see solicitor as priority. Also restricted amount of time Practical support could be offered (ie facilitating attendance at initial appointments) • Interruptions (solicitors/called to court) • Women declining – reasons recorded for ALL occasions • No on site IT facilities/multi-based team

16. Challenges and Barriers (cont.) • Would increasing the capacity: • Increase availability and effectiveness of practical interventions? • Increase number of women able to be seen daily? • Provide more data over longer period of time? • What Impact would Expanding service beyond Bristol magistrates court have? i.e., police custody suites- ‘earliest opportunity’ intervention as referred to in Corston Report. • Develop model and links with other agencies- substance misuse/community services. • Development of links with local women’s prison and HMP resettlement services. • Mental health awareness training for women's advocacy workers to assist in Joint assessment process with CARS? • Autonomous Working and ability to undertake data collection needs to remain an ongoing integral part of the role of Women's Advocacy workers • Access to Facilities – IT, administration support?

17. PERSPECTIVE 3: Evaluation

18. Method • Spreadsheet completed by project worker for each woman assessed in 4 months. • Key variables were: • general characteristics of women defendants, • the demand for service, • their home environments and responsibilities, • women’s general and mental health, • their financial status • the nature of their offences. • The project worker qualitatively described for each case the range of services to which women were referred and the short term outcomes of each referral.

19. Demand • 86 women over the four month period • Ranged form 14 in the first month of the pilot to 30 women in the final month, with an average of 22 • A large number of women (46.5% 40; n=86) were only seen once by the project worker, more than half (53.5%; 46 n=86) were seen 2 or 3 times.

20. Home environment • majority are single (72.1%; 62; n=86) and in social housing (43.0%; 37; n=86). • A quarter experience rough sleeping (26.7%; 23; n=86). • More than half have suffered domestic abuse (55.8%; 48; n=86). • Around a quarter have no children (25.6%; 22; n=86), half have 1 or 2 (48.9%; 42; n=86) and a quarter 3 or more children (23.3%; 20; n=86). • Half (48.8%; 42; n=86) are carers (of children, of older parents etc)

21. Deductions • Unsupportive home environments. • family network is absent/non-conducive to social capital generation. • social capital: “benefits derived by individual (s) through their membership of a social network”. • In functional home networks (family or friendship networks), women access knowledge resources held by network members, e.g. guide disability allowances, facilitate efforts to find employment, cooperate by providing child care/parenting advice. • Dysfunctional family networks provide none of these benefits. • Service is alternative social capital source. • Provides knowledge resources and practical/emotional support directly • Links them to other services/formal networks from which these benefits can be derived. • Sustainability: services do not replace family network but strive to repair support accessible in the home environment in first place.

22. Women’s Health • PHYSICAL • A third with physical disability (30.2%; 26; n=86); • A third with physical health issues (39.5%; 34; n=86) • A small percentage (8.1%; 7; n=86) pregnant Majority of women registered with a General practitioner/doctor (87.2%; 75; n=86) • MENTAL • Half of women have a mental health issue (55.8%; 48; n=86) • Limited numbers self harm (16.3%; 14; n=86), • Alcohol (26.8%; 23; n=86) or drug misuse (37.2%; 32; n=86) Less than a quarter of women in current or past contact with mental health services (22.1%; 19; n=86).

23. Deductions • Need to address the health needs of this population. • High level of reported mental health issues appears to be in contradiction to the poor attendance of CARS service in women defendants • High level of reported mental health issues appears to be in contradiction to the number not ever known to mental health services

24. Offending and reoffending • Evenly distributed between custody and bail (53.5%; 46; n=86). • For many not first dealing with the CJS, 57% (49; n=86) with at least 1 past conviction • Most frequently recorded offence reported related to theft or burglary (28.3%; 26; n=92) followed by assault (15.2; 14; n=92);

25. (see hand outs) Support needs

26. Deductions • Women have multiple needs (e.g., housing, benefit and financial advice to career/education advice, general counselling, physical and mental health support). • Direct referral to CARS on entry to CJS may be inappropriate or of less priority. • Pilot acts as triage service in which women are referred to more specialised CARS service, if and when, a mental health issue raised. • Referred to another service alone, or in conjunction to a referral to CARS, if other needs take priority. • Service acts as gatekeeper between CJS and health and social care services and therefore has scope to improve interagency working • Little reason why such a triage service should be limited to female defendants, as it is likely that male defendants will also have multiple, albeit different, needs. • Two dimensions of support: • practical (e.g. help with making housing applications and the collection and transfer of personal belongings from a hostel to prison) • Emotional (e.g., bereavement counselling and relationship guidance). • Support required for woman herself but also required for a family member.

27. Challenges • Can this service help replace/repair the home environment of these women? • What are women’s perception of mental health liaison services in court and mental health services in general? • Do women favour a more generic women’s court pilot service and what are the reasons behind this? • What could the medium term impact of the service be: e.g. the uptake of the services to whom they are referred; re entry into employment and education, etc.? • What could the long term effects of this triage service on mental health, physical health and rates of re-offending? • Could this service improve interagency working and if so, how?

28. GROUP WORK

29. Instructions for participants • Three perspectives presented (CARS, Women’s advocacy worker, Evaluator) • Review the challenges and barriers from each presentation (see handouts) • In groups, identify three key issues from these and then develop strategies whereby these issues may be addressed in practice • Discuss how this piece of pilot model may fit into/assist/inform your own services • Feedback to the workshop

30. Contacts • Helen Bell: Helen.Bell@missinglinkhousing.co.uk • Anita Gukhool or Paula May (CARS): Longmead House HMP Bristol 19 Cambridge Rd Horfield Bristol, BS7 8PS • Dr Sarah Hean shean@bournemouth.ac.uk