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- Case for change
Case for change
Download a pdf of our case for change or read it here.
Go back to the covering letter to parliamentary candidates.
Prevention and early intervention
Identifying and supporting emerging needs
Revolving Doors Agency was established 16 years ago in response to concerns about people with mental health problems caught in a cycle between homelessness, prison and psychiatric hospitals. We have been a constant voice in the debate ever since, working to ensure that policy makers, commissioners and practitioners take account of the needs of this group.
Over time there have been many changes, including improvements in services for people with the most acute mental health conditions and a reduction in the numbers sleeping rough. Alongside, changes in the criminal justice system have brought improvements for victims, communities and made a genuine difference in preventing offending and rehabilitating offenders.
Health services in prisons, for example, are now part of the NHS, and the recent national offender health plan should lead to further improvements. Revolving Doors is helping as a member of the offender heath National Advisory Group. But one group is still at risk of missing out: women and men with multiple problems or needs, including common mental health problems, who are in repeat contact with the criminal justice system: what we call the ‘revolving doors group’. We estimate that they number at least 60,000 individuals in England at any one time.
Our job is to offer solutions for frontline workers, for locally delivered services and for national policy. Our solutions are endorsed by police and prison officers and local authority commissioners. They know what works.
Alongside this Case for Change we are launching our new Strategic Plan which sets out how we will work with policymakers, local leaders, commissioners and people with direct experience of the problem to find and share solutions and create the change that is needed.
Each year 65% of people starting a prison sentence – that’s over 60,000 people each year – are on sentences of less than one year. The vast majority spend less than 3 months inside having committed low level crime, and are not subject to probation on release. This offers little opportunity for rehabilitation.
Although they get virtually no support when they leave jail, this group often face multiple challenges. These include low level mental health problems, drug or alcohol problems and homelessness. Often this is on top of low educational attainment and unemployment. They are much more likely to have been brought up in the care system than the general population, less likely to have done well at school and more likely to have other health problems. All these problems exacerbate each other.
In short, they are in need of support. And yet public services are very poor at meeting their needs, focusing instead on people who have one acute problem or who are better able to organise their own support.
Perhaps unsurprisingly then, short-sentenced prisoners are more likely to reoffend, causing more problems to themselves, their families and their communities – in other words, to your constituents.
And because they are not effectively rehabilitated, they can end up costing far more to deal with through the criminal justice system than if they were given effective joined up support in the community. The cost of re-offending by this group is estimated at between £7 and £10 billion a year.
Revolving Doors has been working to understand the problem for 16 years. We have also developed and tested solutions – such as the pilot Link Worker schemes.
Crucially we bring people together: police, prison workers, health professionals – and give service users, including people who have been involved in the criminal justice system, the chance to talk to them and help shape the solutions which might make the most difference.
In the past few years the number of offenders serving short sentences has changed very little and is roughly the same level as it was 10 years ago. If their sentences are less than a year adults are unlikely to receive help with resettlement or rehabilitation.
As we have seen, these are often vulnerable people who without such support run the risk of re-offending – and many do end up back in prison soon after release.
Revolving Doors works with prisons helping them deliver services and support to this group of people to prevent them from reoffending.
In HMP Lewes, for example, we brought together senior managers from the prison with local housing managers in nearby Brighton as we recognised that each was experiencing a different side to the same problem. The housing teams were finding many ex-prisoners sleeping rough or without settled accommodation in the city who had common mental health problems or diagnoses of personality disorder. This was in turn leading some of them back into criminal activity that might have been avoided if they’d had access to housing. But for people on short sentences little was being done to help people find accommodation on finishing their sentence or help them with their other needs.
Through this joint-working a new service has been established targeting people on short sentences as soon as they arrive in the prison, offering a full assessment and linking them into services in the community. This is starting to help reduce the homelessness problem in Brighton and give the ex-offenders a better chance of rehabilitation.
Prevention and early intervention
Of course it’s best to stop people slipping down into crisis that can lead to crime in the first place. This is why prevention or early intervention is so important. Getting the right help to people before there is an offender. And before there is a victim.
Warrington is like many towns and cities up and down the UK. It has seen many changes including initiatives such as neighbourhood policing teams that help the community feel safer. Day to day, the police and other agencies work hard to keep communities and citizens safe and to prevent crime.
But some of Warrington’s residents don’t have access to services or to support, and can end up in difficulties, causing harm to themselves and others. Often these are adults with common mental health problems, who may face other difficulties and are in regular contact with the police.
Working with Revolving Doors Agency, the police in Warrington identified a need to provide better support for the people who they were seeing more and more frequently and who seemed to be involved – often as victims – in lots of the issues in their neighbourhood. Together with the local authority, health partners and 20 other local charities, we helped them to develop an approach which is now successfully supporting people and making communities safer and helping services operate more efficiently.
Police officers can now refer adults who they think might have common mental health problems direct to the Revolving Doors Service based in the Criminal Justice Liaison Team, part of the local mental health services. The police don’t necessarily make arrests but if they are concerned about someone they can make a referral.
The team meet the people the police have referred in their home or community and assess all their needs, not just their mental health issues. They are then supported to link into services from a full range of agencies or worked with directly over a few weeks if needed. The result of this partnership working is that the community feels safer, crime is being reduced and individuals’ lives are back on track.
As with all our partnership work, our role is as a catalyst and expert: working with frontline agencies like health services or the police to identify local needs, and bringing them together to look at how existing services can be adapted to meet those needs and existing resources used more effectively.
Identifying and supporting emerging needs
The context we work in is constantly changing. So one of our roles is to identify, understand and help shape responses to new needs that emerge over time. Areas we have identified and begun working on with partners are older people, young adults and families. Throughout all of this work, our emphasis remains on bringing people and organisations together, and crucially supporting service users to shape the provision they need.
Older people: the needs of older people who have common mental health problems and are involved with the criminal justice system are often missed by service providers
Transitions to adulthood: young people with multiple needs face particular challenges as they enter adulthood. There is often a lack of coordination between children’s and adults’ services and people can all too easily fall in the gaps. Revolving Doors is part of the Transitions to Adulthood Alliance who are looking to develop effective policy solutions to help young adults in this situation.
Families: people who are in contact with the criminal justice system and have multiple or complex needs care about their families, and need their support, just as much as anyone else. But for them the issues may be more urgent: for a mother who is in prison, or under a treatment order, there will be the fear or the reality that she may lose access to her children.
Women: Experiences of multiple problems and common mental health problems are high among the female prison population. We are working with partners in prisons and in the community to improve services for women and to better understand how to support people with multiple needs in relation to their families.
Involving people with direct experience of the problems we are talking about is central to our approach at Revolving Doors. They know better than anyone why they ended up in crisis and what worked to help them escape.
Our national service user forum brings together people from different areas of the country who have experienced mental health and other problems and have had contact with the criminal justice system.
The forum is now integral to our work and we are grateful for the time and effort the forum members put in to ensure that our work is rooted in the reality of people’s experience.
Each member has a powerful story to tell about their own lives. You can see some of these stories here.
Collectively they provide invaluable insight into how services do or do not work. We provide training and facilitation to build members’ capacity to feed into policymaking and service design and improvement.
Recently members of the forum helped to develop police guidance on working with people with mental health issues, informed the Government’s new national framework for mental health and will be part of a service user and carers panel helping the government implement its offender health strategy.
Forum members played a large part in the development of our new strategy and will be at the forefront of our work over the next five years.
Based on our experience, and on what service users and front line workers tell us, we know that it is possible to break the cycle and help people make lasting change to their lives, making communities and people safer as a result. We are currently developing an economic modelling tool to show how this is also cost effective.
Despite this at the moment the sort of services that work are few and far between. Local areas are not required to provide them and other priorities mean that usually it just doesn’t happen. Where they do exist, without policy support, services are at risk of being cut.
Changing that is our challenge. But to do that we’ll need the energy, commitment and support of a range of partners – not least MPs and other parliamentarians and policy makers. We therefore ask you to support our call to action set out below.
We want the next government to:
• Consult on a Green Paper leading to a truly joined up, cross departmental “multiple needs” strategy to drive the necessary reform of public services.
• Use this to inform a new crime and reoffending strategy that focuses on people who are in repeat contact with the criminal justice system.
• Increase access to services for offenders on short prison sentences to help them with housing, health and treatment needs especially immediately on leaving prison.
• Ensure the pathways established within the criminal justice system – to help people cope effectively with all aspects of rebuilding their lives – are supported back in the community by local services.
• Incentivise and prioritise local service providers to share ownership of cases across areas of responsibility (e.g. drugs, alcohol, mental health, housing) when people are coming out of the criminal justice system.
• Local authorities, health commissioners and their partners take responsibility for this group and work together and with service users to develop and implement a local strategy to meet local need.
• Ensure service user experience is monitored nationally and locally to help identify new issues and potential solutions.
And importantly, front line services must
• Identify someone to be the lead person working with each individual who will have the authority and responsibility to work across agencies to ensure services are in place.
• Make available officers and practitioners within police stations or other front line services who have an understanding of mental health issues.
• Involve service users in the planning and development of services.
Taken together we believe this can make a big difference to some of the key challenges the next parliament will face.
We do hope you can support these calls, and would be delighted if you could stay in touch with us.
Please do contact us to show your support and to keep in touch with us here at Revolving Doors.
Our vision is an end to the revolving door of crisis and crime, when anyone facing multiple problems and poor mental health is supported to reach their potential, with fewer victims of crime and safer communities as a result.
We know this is achievable, but only if we can convince others, including MPs, to join us in working for change.
