The need for a distinct, radically different, visibly-led, strategic, proportionate, holistic, woman-centred, integrated approach Women in Forensic Services Workshop presentation Barcelona 5 February 2009
Key policy guidance and reports The recommendations for women offenders in "Mainstreaming Gender and Women's Mental Health" (DH 2003). In conjunction with the consultation document in 2002 Into the Mainstream, this is singularly the most comprehensive policy relating to addressing the mental health inequalities of women, including those who offend. The review of mental health of women in custody "Women at Risk" (NIMHE/CSIP 2006). The recommendations made in HMIP thematic review - The mental health needs of prisoners (HMIP 2007) DH (2003) Personality Disorder: no longer a diagnosis of exclusion DH (2006) Supporting Women into the Mainstream Commissioning women-only community day services DH (2006) Tackling the Health and Mental Health Effects of Domestic and Sexual Violence and Abuse DH (2008) Refocusing the Care Programme Approach Policy and positive practice guidance Gender Equality Duty (2007)
Improving Health, Supporting Justice Women s Programme The transfer of responsibility for the commissioning of all prison healthcare services was successfully completed in April 2006 and funding is now managed in line with the rest of the NHS through the bundling process. The historical policy of meeting the health needs of offenders whilst they are serving a custodial sentence did, in financial terms, largely remain unchanged throughout this period. In order to build on the benefits of the transfer to the NHS as it goes through a process of reform in the community, a new Offender Health unit was established in 2007. The Department of Health, The Department for Children, Schools and families, The Ministry of Justice, The Youth Justice Board and The Home Office are working together to develop recommendations on how to improve the health and social care of those people who come into contact with the criminal justice system.
Improving Health, Supporting Justice Women s Programme In November 2007, a strategy framework Improving Health, Supporting Justice was published for consultation. This consultation period completed on March 4 th 2008. Alongside this, the publication and resulting Government response to Baroness Corston s report, looking at the specific needs of women in the criminal justice system, has resulted in the creation of a new team within the Offender Health Department, known as the Women s Health Team. The Department of Health has very recently published guidance on CPA, Refocusing the Care Programme Approach. In Section 3, there is clear guidance for characteristics for assessing when someone is in need of the (new) CPA. The implications for women of The Bradley Review
Refocusing the Care Programme Approach Policy and positive practice guidance The revisions to the CPA approach include 10 essential shared capabilities: Working in Partnership Respecting Diversity Practising Ethically Challenging Inequality Promoting Recovery Identifying Needs and Strengths Providing Service User Centred Care Making a Difference Promoting Safety and Positive Risk Taking Personal Development and Learning
Women s Health Executive Steering Group (WHESG) to oversee, inform, develop and comment on the women s component of the Improving Health, Supporting Justice strategy
Offender Health, Women s Team The overarching objectives of Offender Health, Women s Team are to: Improve the health and well being of all women who come into contact with the CJS or those who are at risk of offending within the community setting. Support the resettlement of women back into the community, giving advice on appropriate support and health services required to support women from re offending. Focus on early detection of women that are vulnerable within the community setting in order to reduce the risk of offending. Span from early detection in the community, to contact with the criminal justice system (including custody) through to release and resettlement.
Priorities This programme invites inclusion of all relevant and interested organisations that support women in the community, in the criminal justice system and in health services to develop clear policy in line with the rest of the Department of Health (DH), Ministry of Justice (MOJ) and HM Prison Service (HMPS) priorities to: Mainstream Women s Offender Health Policy Help reduce re-offending rates Develop better health services and access for women, in primary care, and the community both in and around the criminal justice system
Programme Scope The following issues form the key focus of the Women s Health Programme: Primary and Social Care Mental Health Public Health Substance Misuse Self harm Domestic Abuse BME Learning Difficulties
Programme Deliverables 1 Key deliverables are as follows: Improvement in the health, wellbeing and recovery opportunities for women who are vulnerable and have complex needs. Increased opportunities for diversion away from custody. Accelerated preparations to implement gender equality and transform the way health services for women are delivered. The health and social care of women in contact with the CJS to be given a much higher profile Life skills to be given a much higher priority within the education, training and employment pathway and women must be individually assessed to ensure that their needs are met Women s centres used as referral centres and provide health in reach/out reach services for women who offend or are at risk of offending. The needs of children should be considered where appropriate. Referrals could be by schools, general practitioners, probation, prisons, police, courts, Crown Prosecution Service (CPS), self and other individuals. Community solutions involving health and social care services for non-violent women offenders should be the norm.
Programme Deliverables 2 Key deliverables are as follows: Women s Mental Health programme to be implemented and signed up to in respect the Women s Offending Reduction Programme (WORP) Commissioners and service providers carry out the following: The assessment of the health needs of women in contact with the Criminal Justice System (CJS), in terms of disease prevention, health promotion, risk reduction and treatment of ill health Implementing pathways that aim to address the wider determinants of health and offending amongst women. Integrating the efforts of commissioners and providers from a wide range of government agencies to sustain measures already introduced, develop, and widen the scope of existing pathways to improve health and wellbeing.
Integration with other Related Programmes & Initiatives Pathway development is dependent on effective partnership working with existing DH, NIMHE/CSIP national programmes, namely: Gender Equality & Women s Mental Health Programme as an essential partner and has a specific Corston recommendation (38) CSIP Criminal Justice Leads all Regions and Delivering Race Equality (DRE) Programme National Social Inclusion (NSIP) Programme And across the Criminal Justice System: MOJ Women s Unit/Women s Reducing Re-offending Programme (WORP) HMPS Women & Young Peoples Group HMPS Women s Prisons And across SHAs, PCTs, Communities and Local Government Joint strategic plans Local Authority Agreements (LAA) National Indicator Sets (NIS)