Charity claims prison alcoholismservices are ‘woefully inadequate’

Alcohol services for prisoners were slammed by the Prison Reform
Trust (PRT) this week as “woefully inadequate”, after the charity
published a report detailing long-term neglect and
underfunding.

The trust’s report claims alcohol policy and treatment has been
“overlooked and largely forgotten about,” despite the fact that a
huge proportion of offenders have alcohol problems, making
alcohol-related crime a key issue for the government.

“The Prison Service does not even have an alcohol harm reduction
strategy,” the report says, adding that as there are no Prison
Service central guidelines, there is no expectation on prisons to
develop policies or strategies.

Indeed, a Prison Service survey of half the 138 jails in England
and Wales found that only one prison had a dedicated alcohol
strategy in place.

There are no ring-fenced budgets for alcohol programmes, and as a
result, prison governors have to be creative to find funding,
resulting in the quality of provision being “extremely varied and
limited”.

The health assessment given to prisoners on arrival in prison does
not include a targeted screening programme to identify hazardous
drinkers. According to Dan Howell, south west manager for Prison
Service Plus and Nacro, prisoners are just given a questionnaire
which asks whether they are an alcoholic.

“It is likely they would deny it vehemently, especially to start
with, as people do not want to accept it’s a problem,” he
adds.

The offender also meets a doctor, but Enver Solomon, author of the
PRT report, warns: “They are more likely to pick up drug and mental
health issues, and will be particularly worried about suicide and
self-harm. The issue of alcohol is not on their radar as it is not
on the prison service’s radar.”

A Home Office spokesperson says that Alcoholics Anonymous run
services in around half of prisons and some prisons run alcohol
awareness courses. But the report warns “there is little evidence
that group-based alcohol awareness courses make a
difference”.

Most prisoners serve sentences of less than two years, yet
short-term prisoners are not eligible for drug treatment programmes
that include an alcohol element, and for them accessing alcohol
programmes is impossible. It is also difficult for offenders to
receive continued support post-release because of a shortage of
community-based services, which have huge waiting lists and are
“chronically” underfunded.

Yet this multitude of barriers affects a huge group, as just over
40,000 of the 60,000 sentenced prisoners are hazardous alcohol
users. Almost half of these will have a severe alcohol dependency
problem requiring intensive treatment. According to Solomon,
research has shown that 30 per cent of suicides in prisons are
people with a history of alcohol misuse.

Howell says alcohol has historically been the “poor cousin” in
terms of funding. In the mid-1990s, the political spotlight was on
the drug problem, “but it was forgotten that there have always been
many people in prison because of alcohol abuse”.

For many years alcohol users were unable to access treatment
because of the focus on drugs, he adds. While drug programmes
“quite rightly” needed funding, the Prison Service became
“blinkered” and forgot the other issues.

Over the past five years, Solomon believes there has been more of a
shift towards rehabilitation rather than just containment and
control in prisons. However, the focus has remained firmly on drugs
rather than alcohol. “This institutional failure was not borne out
of a planned, intended policy, it was borne out of oversight,” he
adds.

But a spokesperson for the social care charity Turning Point says
alcohol treatment services are neglected across the board, and the
experience in prisons reflects the overall picture.

“Although three times as many people die each year from alcohol
misuse than from Class A drug misuse, there is currently five times
as much money available for funding drug treatment than alcohol
treatment,” he says.

The charity found that the average wait for an assessment and
access to treatment in the community was 18 weeks, although some
people waited 18 months.

But somebody awaiting treatment may continue drinking and their
health could deteriorate. He believes alcohol has not been a
government priority because of its fear “to interfere in something
that is acceptable”.

But change could be on the horizon. Next month, the Number 10
strategy unit is due to publish the long-awaited national alcohol
harm reduction strategy which will “have a specific focus on
alcohol-related crime and antisocial behaviour”.

“The government understands the problems of alcohol-related crime
and is determined to play its part and take action to tackle it,” a
Home Office spokesperson says.

Turning Point believes the strategy poses “a real opportunity to
put more money into treatment and make it a bigger priority”.
However, if the focus is on binge drinking and public disorder, it
will be “a very skewed way of tackling the problem”.

The Prison Service is also preparing an alcohol harm reduction
strategy, expected at the end of March, which Howell believes “can
achieve a change of focus and raise the profile”.

But the PRT fears no additional resources will be made available to
support the best practice within the strategy. “The biggest danger
is that we can have a Prison Service strategy that is effectively
meaningless,” says Solomon. “If there is no money or political
will, there will be a huge gap between the rhetoric and the
reality.”

The Home Office spokesperson says it is “too early to be specific
about resources”.

But Solomon warns that if prisons want to make any progress in
reducing re-offending – a key government priority – a
well-resourced alcohol strategy is needed. “Research shows that if
intervention is provided, this group are less likely to re-offend,”
he adds.

The sector is also clear what is needed. Turning Point says more
treatment in the community is needed to ensure it is “available at
the point of need”. The target to get people with drug problems
into treatment within two weeks should also apply to people with
alcohol problems, the spokesperson adds.

Howell insists that effective screening is essential “to get to the
root of the offending, which can very often be alcohol”. Skilled
people are needed to talk to offenders when they arrive in prisons
about any alcohol problems, rather than giving them
questionnaires.

“What a lot of people fail to see is that prison is a very
important time in a person’s history, especially if they have
substance misuse problems as motivations [to tackle them] can be at
the strongest level,” he adds.

However, services in the community and prisons need to be made
attractive to people with alcohol problems, and not necessarily
always grouped together with drug services. This can often deter
people with alcohol problems from seeking help because they may
perceive themselves culturally different from drug users, Howell
warns.

Solomon calls for ring-fenced treatment programmes in prisons,
including motivation-based courses for hazardous drinkers and
long-term intensive treatment to address addiction in dependent
alcoholics. There should also be onward referrals set up for those
on release from custody to provide offenders with continued support
in the community.

“The Prison Service should ensure that every prisoner with alcohol
problems has an appointment with a GP after release,” Solomon
urges. If offenders have no fixed address, they cannot access a GP,
and if they can’t do that they will find it difficult to access
support services, he warns.

Solomon also suggests that non-violent offenders with alcohol
problems could be diverted into community sentences in the same way
that drug-misusing offenders are given a drug treatment and testing
order.

However, the bottom line seems to be that resources are needed to
enable prisons to carry out this work. “There needs to be as much
money available as has been provided for drug treatment,” urges
Solomon.

“This is not completely adequate but it would be far better than
what is currently available.”

– Report from enver.solomon@prisonreformtrust.org.uk 

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