a prevalence study of alcohol amongst offenders in the probation and prison services in north east...
TRANSCRIPT
A prevalence study of alcohol amongst offenders in the
probation and prison services in North East England
Dr. Dorothy Newbury-Birch Senior Research Associate
_______________________________↓ Not charged
40% of all cases pled or found guilty
17
12
20
2
2
7
3
37
0 5 10 15 20 25 30 35 40
Cautioned by police
Other police disposal
No further action by police
Defendant bound over
Case dimissed/jury or judge directed acquittal
Case terminated by CPS
Pled or found guilty in the Crown Court
Pled or found guilty at Magistrates Court
Percentages
From arrest to conviction: final outcome of cases
_____________________________________________↓ 49% of all cases do not get to court
↑ 40% of all cases convicted_____________________________________________
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 % missed using OASys
Abstainers -5%Low Risk -12%Hazardous Risk 73%Harmful Risk 46%Possibly Dependence 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)
£5 saved to CJS (UK alcohol treatment trial)
For every £1 spent on alcohol treatment
What we do know…..