Successful rehabilitation: the experience of charities working with short sentenced offenders (less than 12 months) with substance misuse problems after discharge from prison

An individual released from prison after a period of time is more likely to experience mental health problems (Bradley, 2009). That individual often faces issues like unemployment and homelessness; drugs and alcohol are then used to overcome problems, leading to re-offence to fund the habit. The criminal justice system and the voluntary sector have always worked together to support ex-offenders on their way towards a successful rehabilitation. This study was designed to conduct a primary qualitative research to investigate charities and explore how they support ex-offenders. It was found that although they both work towards the same objective, the government and the voluntary sector do not share the same opinion on what “success” means. This was understood to be a determinant factor in the way government policies are designed and how charities support their clients. As recommendations, policies on offenders management should be made not only based on cost effective procedures but by considering the needs of the offender. Also, future studies could follow the implementation of the new regulations, and include the service users in the research, in order to explore their perspectives on the services they receive as part of their rehabilitation as well as their mental well-being

Contextualising transforming rehabilitation: supporting short sentenced offenders with complex needs in a time of policy change

This thesis presents the findings of a qualitative exploration of the concept of effective rehabilitation within Transforming Rehabilitation (TR) – a programme implemented in 2015 to review the way offenders are rehabilitated in England and Wales. The study focuses on the programme’s radical changes to the commissioning, delivery and payment of rehabilitation services i.e. Payment by Results (PbR) and the mechanisms - as framed by Pawson and Tilley (1997)’s realist approach - through which it influenced the provision of effective rehabilitation in the community, especially to short-sentenced offenders with complex needs. Policy documents are examined to establish the theory behind TR. Interview data from service providers (including private and third sector organisations) and service users, across England, is used to explore the implications of TR on the ground and effective rehabilitation from their perspectives. This work suggests that PbR as designed under TR works against the principles of effective rehabilitation, which were found to be rooted in the mental health of the offenders. A theoretical perspective on how effective rehabilitation could be achieved and appropriately funded is proposed. The study recommends the adoption of a public health approach to addressing re-offending, with mental health at the forefront of the design of policies concerning offender rehabilitation. Qualitative data for the thesis is available: DOI 10.25500/edata.bham.00000756, https://doi.org/10.25500/edata.bham.0000075

The effects of educational curricula and training on LGBT specific health issues for healthcare students and professionals: a mixed-methods systematic review

Introduction: Poor access of lesbian, gay, bisexual and transgender (LGBT) people to healthcare providers with clinical and cultural competency contributes to health inequalities between heterosexual/cisgender and LGBT people. This systematic review assesses the effect of educational curricula and training for healthcare students and professionals on LGBT healthcare issues. Methods: Systematic review; the search terms, strategy and process as well as eligibility criteria were predefined and registered prospectively on PROSPERO. A systematic search of electronic databases was undertaken. Screening for eligible studies and data extraction were done in duplicate. All the eligible studies were assessed for risk of bias. The outcome of interest was a change in participants’ knowledge, attitude and or practice. Results: Out of 1171 papers identified, 16 publications reporting 15 studies were included in the review. Three were non-randomized controlled studies and 12 had a pre/post-design; two had qualitative components. Bias was reported in the selection of participants and confounding. Risk reported was moderate/mild. Most studies were from the USA, the topics revolved around key terms and terminology, stigma and discrimination, sexuality and sexual dysfunction, sexual history taking, LGBT-specific health and health disparities. Time allotted for training ranged from 1 to 42 hours, the involvement of LGBT people was minimal. The only intervention in sub-Saharan Africa focused exclusively on men who have sex with men. All the studies reported statistically significant improvement in knowledge, attitude and/or practice post-training. Two main themes were identified from the qualitative studies: the process of changing values and attitudes to be more LGBT inclusive, and the constraints to the application of new values in practice.Conclusions: Training of healthcare providers will provide information and improve skills of healthcare providers which may lead to improved quality of healthcare for LGBT people. This review reports short-term improvement in knowledge, attitudes and practice of healthcare students and professionals with regards to sexual and LGBT-specific healthcare. However, a unified conceptual model for training in-terms of duration, content and training methodology was lacking

Qualitive data for the thesis “Contextualising transforming rehabilitation: supporting short sentenced offenders with complex needs in a time of policy change"

Interview transcript

Qualitive data for the thesis “Contextualising transforming rehabilitation: supporting short sentenced offenders with complex needs in a time of policy change"

Interview transcript