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Process evaluation of the drug recovery prison at HMP Holme House

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A positive initiative

Last week (8 September 2023), the MoJ published a process evaluation of the drug recovery prison at HMP Holme House. Undertaken by Tammy Ayres, Ruth Hatcher and Emma Palmer of Leicester University, the research looks at the implementation of the Drug Recovery Prison (DRP) which began in April 2017 as a three-year initiative at HMP Holme House, jointly funded by NHS England and HMPPS. The DRP consists of a whole prison approach to tackling drugs in prison and aiding long-term recovery.

Wider issues important

The researchers not that while the process evaluation examined the strategic components of the DRP and their implementation (e.g. security, activities), it also referenced some beyond the remit of the DRP, which were the responsibility of HMPPS (e.g. basic needs, education and training) and/or NHSE (e.g. healthcare) but had the potential to undermine and/or act as a barrier to effectively implementing the DRP and its initiatives. Whilst issues with these wider components are noted in the report, they are not interpreted as a failure of the DRP but instead reported to inform the wider context that is necessary to facilitate successful implementation in the future. There were two waves of interviews with prisoners.

Key findings

Overall, the majority of the DRP was successfully implemented and the key findings from the research show that the DRP is perceived to have had a positive effect on prisoners and staff and appears to have met many of the expected outcomes. However, barriers to the implementation of the DRP have also been highlighted, indicating the need for further work across several areas of the DRP. The findings are organised based on the strategic components of the DRP.

Safety and Security

Most prisoners were aware of at least one of the new security measures, particularly the photocopying of mail, drug dogs and body scanners, which were three of the most visible measures. Both staff and prisoners thought most measures had some impact on security, with prisoners reporting the following measures as having the most impact: drug dogs, body scanners and photocopying of mail, which may reflect their higher levels of visibility.

Environment, Cultural Change and Rehabilitation

All staff were able to describe the aims and initiatives of the DRP, but some did not see how their job might be associated with the DRP, even when their post was funded by the DRP budget. This was also true for the majority of prisoners who reported awareness of the DRP but there seemed to be some confusion amongst the prisoners as to the aims and ethos of the DRP. Both the staff and prisoners demonstrated a lack of awareness as to the whole prison approach adopted by the DRP.

Most staff had embraced the security elements of the DRP, but it had been more difficult to garner support for the demand reduction elements of the DRP. Staff spoke of the need to change the culture within the prison to allow the DRP to become fully embedded and supported but outlined that this type of cultural change takes a long time to cultivate and felt that more work was required to bring uniformed staff on board. 

You can see prisoners’ views of the the impact of the DRP on different factors in the graphic below.

Care and wellbeing

Just over a third of prisoners (37%) at wave two reported that they perceived the DRP to have impacted positively on healthcare provision (although 24% thought it had impacted negatively and 39% perceived there to have been no change). A quarter of prisoners reported that the DRP had positively influenced health and well-being for themselves and/or other prisoners.
Despite the move to a house block-based healthcare model, the majority of prisoners at both waves either had not noticed a change in getting to see healthcare or were not sure, although this may have reflected the level of need among the prisoners.

Although very few prisoners noticed a change to drug treatment since the DRP had been implemented, at wave two almost a third of prisoners reported that access to the Drug and Alcohol Recovery Team (DART) had improved since wave one. The visibility of DART staff was observed as key factor in this. At both waves the majority of prisoners knew about the services offered by the DART and most prisoners reported positive perceptions of DART staff and treatment.

Continuity of care

Both staff and prisoners who had experience of the Connecting Communities Team’s work were very positive about the support they provide to prisoners before, on, and after release. 

Use of medications and illicit drugs

Although the findings were mixed, the prisoner questionnaire and the qualitative data from the prisoners and the staff, indicate a perceived reduction in drug use and availability in HMP Holme House.

The perceived reduction in substances was further felt to have provided both staff and prisoners with a calmer, safer environment that was more conducive to rehabilitation and recovery. Both prisoners and staff, however, reported that reduced drug availability had led to an increase in the brewing of alcohol and the trade of prescription medications.

 

Thanks to Andy Aitchison for kind permission to use the header image in this post. You can see Andy’s work here

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