Swindon Borough Council’s public health team has worked with the two organisations which provide in-reach services into prisons to develop a new residential rehab pathway for women when they leave a prison estate.
The 24-week residential rehab pathway
When the government provided extra funding for substance misuse services last year, the public health team at Swindon identified the support given to women leaving prison as a priority area for investment.
Swindon Substance Misuse Public Health Specialist Richard Steptoe said: “Like many areas we have an entrenched, ingrained cohort of young females who are caught in a cycle of short two to three-month prison sentences. They are very vulnerable and – we felt – were not getting the support they really needed. They are often involved in street- based sex work and have long-term substance addictions.
“When they are released they either walk back on to the streets or have short stays in resettlement housing and tend to fall into the same life again. We wanted to try something different, to provide more intensive support.”
Working with Turning Point and Nelson’s Trust, which provide in-reach support in prisons, a new pathway was designed that offered women a sustained and holistic programme of help once they are released. The first step is a 24-week stay at a residential rehab unit.
Mr Steptoe said: “We actually looked at a shorter option – 12 weeks – but because of the trauma some these women have encountered we felt that 12 weeks would not allow these women to address some their underlying past hurt and trauma.
“The women may only just have been making progress by that point and we would not want them to leave a safe residential unit in a vulnerable position. Providing the support for 24 weeks is resource intensive, but it gives individuals the best chance of a successful outcome and most importantly re-creating their lives and living substance free.”
‘I’m so thankful for the help’
Proof of that can be seen through the story of Andrea (not her real name). She was caught in a cycle of re-offending and was well-known to the prison and substance misuse service. She has six children - four have been adopted and two she still had supervised contact with.
A significant turning point for Andrea was while she was in prison in late 2021. She always engaged well with the Nelson Trust prison team and feared if she did not change her lifestyle she would lose contact with the children she still saw.
She expressed to the prison team on a number of occasions that she would love to have the opportunity to restart her life and said she was very excited at having the possibility of doing so.
A number of multi-agency meetings were held between the prison, probation and public health commissioners and it was decided she would be a good candidate to join the residential rehab programme. In early 2022 she was released and went straight to the rehab centre. A detailed care plan was developed for her, which included weekly counselling and EMDR psychotherapy alongside other support.
This included attending a minimum of two mutual aid groups per week and those supporting her said she “really embraced” the importance of getting a strong recovery support network.
She attended several other groups too, including relapse prevention, emotional management and a “helping women recover” group, which uses theories of psychological development, trauma and addiction to help people explore and process the underlying reasons why they use substances as a coping mechanism. The programme consists of 17 sessions which cover self-esteem, sexism, relationships, domestic violence and trauma.
Andrea is coming towards the end of her stay at the centre and is in the process of moving to a re-settlement project. She is full of hope for the future and has set her sights on doing some volunteering work. “I am so thankful to have had this opportunity and so pleased I can now live a life free from addiction and continue to repair relationships with my family and children.”
Following the success of the initial pilot, more funding is being set aside for the coming year to pay for other female prisoners to go through the rehab service.
“We are really pleased with how the pilot has gone,” said Mr Steptoe. “Andrea’s story is an illustration of what can be achieved. She will continue to receive support once she is moved. That really is the key – providing long-term help, that is gradually reduced as appropriate.
“There are other services we are investing in too. We are going to pilot a day care programme for people who have been in inpatient detox for substance misuse. There will be peer support, mindfulness, art therapy, CV writing and job support. The public health benefit should be significant.”
Richard Steptoe, Substance Misuse Public Health Specialist, Swindon Borough Council: firstname.lastname@example.org