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Jail: a missed opportunity

May 18 2009
Prison may be the last chance to work with homeless, chronically dependent users A missed opportunity: jail. Our current system of criminalising the chronic substance abuser is allowing the most needy and dependent to slip through the net. Our criminal justice approach of dealing with dependent clients - the thrust of it being about anti-social behaviour, reducing crime or them using illicit drugs - is, for this significant minority, irrelevant. They have reached a point where their downward spiral is out of control. Their physical and mental deterioration is gathering so much momentum that they cannot see the wood for the trees. They might have choices, but they can no longer see them. It's like being on an express train when you can't read the name of the station... It isn't until the train slows down that you can see the stations you are passing through. Prison, for some people, needs to be viewed in the same way: they have a chance to see their choices once again. Whilst in the prison system, they have stopped running. As much as people don't like going into prison, three themes came to the fore from speaking to countless numbers of people who have been through the system and turned their lives around. First, prison saved their lives. Secondly, they were more afraid of what was waiting for them on the outside on release - using, drinking, overdose, crime, homelessness, responsibility, being scared and exited come to mind. They were walking out to failure, ill-equipped to live life on life's terms, but the initial promise of freedom, drink and drugs kept them buoyed. They could not (or did not want to) see beyond that first can, that first fix - "get it down yer neck, loverly". And thirdly, many clients said keeping them out of prison did them a disservice. Most homeless and chronically dependent clients going through this system are passing through. They're having a little breather inside, a lie-down, three squares a day and a clean bed. And due to the nature of their low-tariff offences (shoplifting, breach of the peace, drunken disorderly), their sentences will be counted in weeks rather than months or years. They are the archetypal "revolving door client". Once inside, clients will be given a mandatory detox if they have been using illicit Class 'A' drugs and are not scripted. However, due to the short sentences clients may be receiving, not much else is put in place. This can pose problems of overdose on release, but equally important, another missed opportunity. I am under no illusion that underfunding, manpower, coordination and creative thinking are lacking in these situations. The police are sometimes reluctant to intervene: there is no glamour in nicking homeless drunks over Christmas, even if there is an outstanding warrant out for their arrest, just a lot of paperwork, for very little result! In all fairness to the police, most of them have a good rapport with many of the homeless clients they come into contact with. They also work closely with day centres and outreach teams across London. So, in some cases, they might be doing the person a favour by arresting them. There are now programmes in most prisons for people i.e. RAPT, CARATS and Narcotics and Alcoholics Anonymous meetings; however, these are for people serving longer sentences. It might be that very vulnerable clients could be targeted by the prison liaison worker on a Drug Intervention Programme, working in conjunction with an outreach team and the courts. I say this because most of the clients going through this system would be local clients, using local prisons and known to most services in any given borough. We should be taking advantage of these small windows of opportunity, and getting them whilst they're drug- or alcohol-free. We could create posts for dedicated workers to work with this client group. I hope people don't think I'm being too draconian. It's a certainty that due to their lifestyle, they will be up in front of the courts on some drink- or drug-related charge. I am talking about a relatively small number of clients. I'm talking about those clients who have been excluded from services, or barred from day centres, hostels and the like, those clients whose health and options have taken a real turn for the worse. Maybe its time that these clients are reminded in no uncertain terms, whilst they are drug- or alcohol-free, that they can't drink or use successfully. During a conversation I was having two years ago regarding a difficult group of six clients, a colleague said: "Like it or not, they're going to stop using. They're going to end up in prison, in rehab or in a box, but they're going to stop, so they might as well stop now!" Out of that group, two are clean, one died, one is in prison doing three years, one is still using and the sixth has gone off the radar. Well, Merry Christmas everyone and a Happy New Year.
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