Developing drug treatment services within the criminal justice system: the Greek case

Developing drug treatment services within the criminal justice system: the Greek case Gerassimos Notaras Sociologist, President of the Board of Management of KETHEA Ljubljana, EFTC Conference, 6-9 June 2007

Presentation Overview 1. What is KETHEA? 2. Interventions in the correctional setting 3. Treatment in the correctional setting 4. KETHEA’s current network of interventions in the correctional system 5. Evaluation after 19 years of KETHEA’s interventions in the correctional setting 6. Current picture of the correctional setting 7. Planning the future

1. What is KETHEA? Pilot Programme: T.C. Ithaki in 1983 Therapy Center for Dependent Individuals (KETHEA) started operating in 1987 KETHEA Today: in special consultative status with the UN Economic and Social Council (ECOSOC), member of the World Federation of Therapeutic Communities (WFTC), member of the European Federation of Therapeutic Communities (EFTC) one of the principal implementation organisations of the National Action Plan on Drug Addiction treatment in Greece

19 Counselling Centres KETHEA Services Network 16 Treatment Programmes 12 Rehabilitation Centres 18 Family Programmes 14 Prison Programmes 2 Vocational Training Centres 1 TC in Prison 2 Prisoners’ and Ex-Prisoners’ Support Programmes 1 Treatment Programme for Legal Addictions 1 Multicultural programme for prevention and treatment 1 Harm reduction programme, Drug free psychosocial intervention 1 Legal support for the members 4 Transitional schools Help line for relatives and friends of drug-users Prevention department Research and Training Institute Printing Unit

1. What is KETHEA? 2. Interventions in the correctional setting 3. Treatment in the correctional setting 4. KETHEA’s current network of interventions in the correctional system 5. Evaluation after 19 years of KETHEA’s interventions in the correctional setting 6. Current picture of the correctional setting 7. Planning the future

Law 1729/ 1987, art. 12, 13 and 14: special treatment of addicted drug users with legal problems • KETHEA started implementing interventions within the correctional system(1988) • After 19 years, law application has been discouraging • Special correctional establishment only recently in operation (2002): 40 out of 4,500 addicted prisoners currently in treatment • Alternative means were never implemented  KETHEA’s interventions from motivating to consultative • In 2000 women’s prison in Korydallos (2002 National Action Plan)

Corruption • Treatment in the correctional setting faced with a two-fold system conflict: • Detainment • Subculture • KETHEA’s interventions: • Without a specific legal framework, • Without prior needs’ assessment of the population, • Without evaluating and prioritising the needs and capacity of the penitentiary establishments, • In a fragmented way, and dependent on each correctional establishment command • With often cessations, up-settings and cancellations

Prisoners’ and Ex-Prisoners’ Support Programmes People received services Counselling 2003 2004 2005 2006 ATHENS: Men’s Prison in Korydallos 225 206 247 225 ATHENS: Psychiatric Establishment for Prisoners 25 23 31 35 ATHENS: Women’s Prison in Korydallos 94 81 95 90 VOLOS: Penitentiary Establishment for Minors in Kassaveteia 50 59 50 21 THESSALONIKI: Judicial Prison of Diavata 191 222 229 182 THESSALONIKI: Military prison of Diavata 8 4 5 5 THESSALONIKI: Judicial Juvenile Prison 13 10 8 TRIKALA: Prison of Trikala 24 54 42 KRITI: Prison of Neapoli 54 74 79 KRITI: Prison of Alikarnassos 29 35 40 KOMOTINI: Judicial Prison of Komotini 26 61 AVLONAS: Juvenile Correctional Institution 52 73 52 KASSANDRA: Rural Prison of Kassandra 24 49 ATHENS: Counselling Centre as the Juvenile Court 34 33 21 26 Total 593 767 953 911

Treatment/ Rehabilitation/ Family Support 2004 2005 2006 ATHENS: Therapeutic Community in the Women’s Prison in Korydallos 32 21 50 ATHENS: Released Prisoners’ Reception Centre 68 59 117 THESSALONIKI: Support Centre for Prisoners and Released Prisoners 40 90 83 ATHENS: Family Support Programme 62 77 102 Total 202 247 352

Conditions of Premises –Frequency –Members of staff Premises Frequency Members of staff Men’s’ Prison in Korydallos 25 m2 NEU Daily Morning Afternoon 7 groups 95 persons HU + 2 TSM Psychiatric Establishment for Prisoners 20 m2 NEU Once a week 15 persons per group HU + 2 TSM Women’s Prison in Korydallos 150 m2 NEU Daily Treatment, preparation 15 persons per group HU + 3 TSM + 4 T Juvenile Correctional Institution Avlonas 2 rooms -35 m2EU -15 m2 NEU 3 times a week 36 persons HU + 2 TSM Men’s Judicial Prison of Diavata 40 m2 EU Daily 2-3 groups of persons HU + 4 TSM + 1 T Women’s Judicial Prison of Diavata 25 m2 NEU 2 times per week Therapeutic group and once a week traingin 13 persons HU + 1 TSM + 1T Juvenile Judicial Prison of Diavata 15 m2 EU 5 persons; 1 TSM Military Prison Thessaloniki 10 m2 NEU Once a week 3 persons HU + 1 TSM Rural Prison of Kassandra 45 m2NEU 2 times per week treatment HU + 1 TSM.+ 1T Judicial Prison of Komotini 30 m2 EU 2 times per week 20 persons HU + 1 TSM Penitentiary Establishment for Minors in Kassaveteia 1 room EU 2 times per week 12-15 persons 5 TSM in rotation Judicial Prison of Trikala 12 m2NEU Once a week 13-17 persons 3 TSM in rotation Judicial Prison of Neapoli 8 m2 NEU 2 times a week, open participation 2 TSM Judicial Prison of Alikarnassos 15 m2 NEU 3 times a week, open participation 2 TSM Judicial Prison of Chania In a common room that used as kitchen-dining room Once a week 15 persons 2 TSM Prison Agios Stefanos -Patras In the library NEU 2 times per week for 2 hours 40 participants, 0 waiting list 1 TSM [1] NEU= Non exclusive use [2]HU= Head of Unit [3]TSM=Treatment Staff Member [4] T= Trainers (paid by the hour) [5] EU= Exclusive Use [6] The programme is not operating temporarily due to the last riot that took place in the prison.

KETHEA’s interventions take place in very difficult conditions • There is a sufficient number of inmates in the therapeutic and training groups. • The number of inmates who receive counselling and motivation services, usually, and treatment services in two cases is very small in comparison to the total number of inmates. • It is not possible to refer people to the second stage of treatment after they have completed the first stage of counselling and motivation • A valuable generation of therapists has been created

Skills were reinforced on a theoretical level • KETHEA’s experience led to one major conclusion: Treatment in prison is possible. • Effective treatment in prisons reinforced by two external evaluations • A certain number of people, were admitted to KETHEA’s Rehabilitation Centres for Released prisoners in Athens and Thessaloniki

Further conclusions • These interventions contributed to the sensitisation of the people and the public opinion • Good cooperation during these interventions, between the correctional personnel, the wardens and the therapists. Whenever disturbed, it was due to “interventions from above” • Often the “system” intervenes in the efforts of the therapists. (prisoner transfer,humiliating behaviours towards the users and or “suspension” of the operation of the programme) • Successful operation of the therapeutic interventions benefited the users in treatment and the overall prison population • Every start is difficult!

1995 56 inmates per 100,000 people 1998 68 inmates per 100,000 people 2001 79 inmates per 100,000 people 2004 82 inmates per 100,000 people 2007 96 inmates per 100,000 people 71% increase of inmates in Greece between 1995-2007 43.4% foreigners in prisons (450/ 100,000) 44% are drug addicted offenders 50% sentenced for less than 5 years

Penitentiary Establishments Capacity No of inmates on January 1st No of inmates on May 1st Prisons Alikarnassos 105 392 404 Kekryra (Corfu) 160 278 235 Patras 780 707 775 (2) Trikala 700 707 (2) 704 Chalkida 120 238 234 Women’s Prison 270 541 (15) 534 (15) Domokos Prison 700 - 145 Jails (dikastikes) Thessaloniki 370 608 (11) 620 (19) Ioannina 80 183 230 Komotini 105 313 (1) 328 (1) Korydallos 640 1941 (7) 2052 (5) Kos 45 89 89 Larisa 450 845 (8) 876 (8) Nafplio 314 502 492 (2) Neapoli (Kriti) 45 118 139 Prevadorio (Amfissa) 100 277 125 Tripoli 65 171 169 Chania 67 132 130 Chios 100 160 160 Korinthos 60 39 42 16 17 Central Prison Supply Storage (KAYF) 38 44 42 Malandrinou 440 438 373 Agrotikes Prisons Agias 146 141 Kassandras 300 254 Tiryntha 200 270 Juvenile correctional institution Avlona 308 288 (212) 296 (196) Kassaveteia 250 162 (37) 175 (29) Volos 65 116 (71) 126 (82) Treatment institutions Psychiatry (Athens) 160 291 313 Hospital (Athens) 60 66 (113) 68 (141) KATK (Thivon) 300 43 40 Total 7543 10370 10595

7. Planning the future KETHEA has planned qualitative and quantitative large scale interventions: • In the action plan for 2007-2010, it included the evolution of interventions for addicted users, in the correctional system. • It has already included in the budget of 2007 the necessary amounts for this year’s interventions. • Since June 2006, it has suggested to the Ministry of Health integrating the interventions in the correctional system in the National Action Plan, which is yet to be announced.

7. Planning the future: (cont) Since 2006, KETHEA is negotiating with the Ministry of Justice aiming at: • safeguarding the interventions planned for the prison settings by KETHEA, • planning approved regulations for the operation of counselling centres and treatment programmes, • improving the conditions of the existing counselling programmes, • creating new treatment programmes, • creating relapse prevention programmes, for users-inmates, • activating the provisions for alternative options instead of incarceration, for drug users and referral to a treatment programme outside the prison.

KETHEA’s new interventions for 2007-2010

Developing drug treatment services within the criminal justice system: the Greek case