A community sentence for women with mental health needs

Image: The Good Loaf Cafe. 

Where studies of mental illness have been conducted with prison populations, the prevalence has been consistently shown to be high.[1] Women offenders’ mental healthcare needs can be even higher than men’s, often as a result of violence and trauma. Community-based sentences are more effective in reducing reoffending and providing support for people with mental healthcare needs. Olivia Rope, PRI’s Policy & Programme Manager, recently visited a pilot programme in England where justice and health authorities are working with civil society and social enterprises to divert women offenders from prison towards a community-based sentence, which includes mental health treatment at a ‘Women’s Centre’.

In Northamptonshire, England, there is a specific community service for women that includes mental health treatment alongside holistic support, through a ‘Women’s Centre’. The Centre gives support not only on mental health but also physical health, education, financial stability, relationships, employment and vocational training, and provides programmes to empower women to be more resilient.[2]

Since the programme started one year ago in October 2017, 75 women have received this community sentence (for either mental health, drug rehabilitation or alcohol dependence treatment), of which only four have breached the order and returned to court.

It is part of a national programme that is a partnership between the Ministry of Justice, the Department of Health and Social Care, the National Health System (NHS) England and Public Health England. The programme seeks to reduce reoffending by addressing the root causes of offending, along with reducing short-term prison sentences. The programme requires a close working partnership between government authorities across health and justice areas and third sector organisations. It is based on the fact that many people in conflict with the law have experienced years of trauma and abuse for which they have received little support, and have poor experiences of health and wider social care issues; therefore, by addressing their mental health, substance misuse and associated social issues effectively through part of their community service, offenders are more likely to engage in treatment and not reoffend.

As women tend to be given short-term prison sentences for minor offences, such community sentences also avoid the harm that prison sentences can have on women and their children. They also better address their needs, including mental health, alongside programmes to address their offending behaviour.

‘When I first moved into my own home, [the support worker] helped with practical things, like how to pay bills. I got lots of support from everyone. You get support from the other ladies too, I’ve never experienced that before, people helping. I lived with a man and he did everything, he took over, took control so doing things for myself was new.’

On the day of their sentencing, women are identified by probation services as being potentially eligible for the programme as part of a community service sentence. Before their appearance in court, an initial screening is carried out which involves a short interview by a third sector support worker, with 34 questions to assess the woman’s mental health status. If this screening indicates that the woman offender is likely to benefit from mental health treatment (or drug or alcohol treatment), a more detailed assessment is carried out by an assistant psychologist, who decides if the woman is eligible and seeks her consent to participate, after sharing information about how the programme works. Mental health treatment – as part of the community sentence – is then recommended as a sentencing option to the magistrate or judge through a pre-sentencing report prepared by the probation services.

This simplified assessment process, which typically takes only a couple of hours, allows courts to seek views and assessments from a broader range of appropriately trained mental health professionals, resulting in quicker assessments and reducing unnecessary psychiatric court report costs. It also enables sentencing judges to give access to effective individualised mental health (or other) treatment as part of a community sentence.

Within five to 10 days of the sentence being handed down, the woman meets with her probation officer, assistant psychologist and support worker, and as part of this an assessment tool is used to visually map out the woman’s needs across the different areas of her life.

‘[The community service order] is harder [than prison] because you have to register all your emotions and you’ve got to change. In prison you can just do nothing, but then nothing changes. It’s harder coming here, but I’m a different person now.’

Aside from individualised psychological interventions (usually mental health therapy provided through bi-weekly appointments), many women are also required to take different courses as part of their sentence which are delivered by the women’s specialist provider, C2C Social Action. These can include confidence building, healing trauma and anger management. Women also have the option to undertake drug and alcohol treatment at the centre and fulfil unpaid work requirements (community service). The Good Loaf, a social enterprise cafe, is located in the same building and provides employment and training support which includes courses such as food safety, employability and hospitality and catering.

On my visit, I was impressed by the level of cooperation across the different criminal justice stakeholder groups (from the courts and probation through to health and the third sector) and the dedication of the staff at the Women’s Centre to provide support, from very practical elements through to psychological therapy. It is clear from meeting the women on this programme that the women-only space is critical to the journey they are on towards rebuilding law-abiding lives. One woman said to me: ‘For a lot of women here, a lot of the problems come from men. It’s daunting coming here at the beginning, if men were here too it would be very hard.’

The Centre provides so much support that even after the women’s sentences have finished – usually after one year – it is common for them  to continue visiting or volunteering at the Centre. One woman explained: ‘My probation is up, but I’m still coming back to help others, giving something back.’

This programme should serve as a model in other countries and contexts, as the benefits are clear: the mental health needs of women who offend are addressed before they escalate to something more serious, resulting in lower reoffending rates and stronger, more resilient women who can care for their children and live self-fulfilling lives in society.

More information

Between 2015 and 2017, PRI conducted a pioneering, multifaceted project which focused on the experiences of women completing non-custodial sentences – specifically community service orders and probation orders – in Kenya, and the investigation of how to best adopt a gender-sensitive approach. The project was implemented with a view to developing a model that is replicable across an international context. Click here to see the project’s resources, including a 10-step model for reform, a short film on making community sanctions work for women and guidelines for incorporating a gender-sensitive approach to social enquiries and pre-sentencing reports.

References:

[1] PRI, Mental health in prison: a short guide for prison staff, 2018, p9.

[2] The Community Sentence Treatment Requirement (CSTR) Programme is a partnership between the Ministry of Justice, Department of Health and Social Care, NHS England and Public Health England. During 2017/18 five pilot areas were selected to test the CSTR, although Northamptonshire is the only women’s only programme. There are three types of treatment requirement as part of the CSTR, one of which is a Mental Health Treatment Requirement (MHTR) and the other two relate to drug rehabilitation and alcohol treatment.