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A prevalence study of alcohol amongst offenders in the probation and prison services in North East England Dr. Dorothy Newbury-Birch Senior Research Associate [email protected] From arrest to conviction: final outcome of cases Pled or found guilty at Magistrates Court 37 40% of all cases convicted 40% of all↑cases pled or found guilty 3 _____________________________________________ Pled or found guilty in the Crown Court Case terminated by CPS 7 Case dimissed/jury or judge directed acquittal 2 2 _______________________________ _____________________________________________ ↓ Not charged ↓ 49% No further action by police 20 of all cases do not Defendant bound over get to court Other police disposal 12 Cautioned by police 17 0 5 10 15 20 25 30 35 40 Percentages From: Entry into the criminal justice system: a survey of police arrests and their outcomes. (1998) Phillips C and Brown D. Home Office Research Study 185. • Research undertaken to inform the Alcohol Pathway of the prevalence of alcohol misuse amongst offenders in the North East of England. Subjects • Three probation areas: – Northumbria – Durham – Teesside (not all offices in each area) • Four prisons: – – – – Durham Deerbolt Holme House Low Newton • All offenders for the month of November 2006 were asked to complete a questionnaire • 715 completed from a possible 1131 cases (63%) Results - Age • 94% of prison cases and 86% of probation cases were men • Half of those who answered were aged between 22-34 [probation 49%, prison 51%] • 25% were aged between 18-21 [27% probation, 24% prison] • 22% were aged between 35-49 [21% probation, 23% prison] • 2% were aged 50 or more [3% probation, 2% prison] Alcohol prevalence • 15% reported that they did not drink (8% women). Alcohol prevalence • In the probation setting 69% of men and 53% of women were classed as having an AUD • In the prison setting 59% of men and 63% of women were classed as having an AUD • This is compared to 38% of men and 16% of women in the general population (ANARP 2004) Alcohol prevalence • In the probation setting 35% of men and 25% of women were classed as ‘possibly dependant’ • In the prison setting 36% of men and 42% of women were classed as ‘possibly dependant’ • This is compared to 6% of men and 2% of women in the general population (ANARP 2004) However… when comparing AUDIT scores to OASYs alcohol scores Audit Range Abstainers Low Risk Hazardous Risk Harmful Risk Possibly Dependence % missed using OASys -5% -12% 73% 46% 14% What’s happening? • Primary Aim - Address evidence gaps associated with SBIs for Alcohol Misuse • Funded by DH; £3.2 million as an action under the “Alcohol Harm Reduction Strategy for England” (2004) • Collaboration between: – Institute of Psychiatry, London – Newcastle University, Institute of Health and Society – University of York Primary Aims of SIPS To identify: 1. The best screening methods 2. The most effective intervention techniques 3. The most appropriate, acceptable and cost effective methods of implementation for detecting harmful & hazardous alcohol consumption across 3 health and social care settings: - Primary Health Care (PHC) - Accident & Emergency Departments (AED) - Probation (CJS) Design Methodology • Pragmatic Cluster RCTs • • North East, London, South East 2 year time span (6 & 12 month follow-up) • Intervention Approaches • Patient Information Leaflet (PIL) • Brief advice 5 minutes + PIL • Extended intervention 20-30 minutes + PIL • Screening Tools • AUDIT: gold standard • FAST: 4 questions • M- SASQ: 1 question • M-PAT: AED related Research Programme Design • For the whole trial participants will be recruited from: – 24 PHC practices – 31 patients from each – 9 AEDs – 131 patients from each – 96 Offender Managers in Probation – 5 clients from each • North East will work with 12 GP practices, 4 AEDs and 43 Offender Managers • The overall aim is to recruit over 2,600 people across the three trials Outcome Measures – – – – – Implementation: barriers and facilitators Identify most effective screening tools Assess effects on drinking patterns Explore most cost effective intervention approach Common measures and design to allow comparisons – Best methods to roll-out nationally (e.g. need for AHWs) What we do know….. For every £1 spent on alcohol treatment £5 saved to CJS (UK alcohol treatment trial)