As the Department of Health’s ‘The National Delivery Plan of the Health and Criminal Justice Programme Board’ (November 2009) notes, work is required to address the mental health and learning disabilities of offenders that the Bradley Report highlighted. Such work is not only in the interests of offenders; the public and particular victims will gain from reductions in re-offending, as well as better prospects for offenders’ children and families. David Haddrick, WYPT’s lead on health matters, notes: ‘... our service users come from the most socially excluded groups and economically deprived communities’.
Offenders cause harm and are often disadvantaged themselves. For example, over 2010/11, Calderdale Probation offenders had an unemployment rate of 62%; for the 18-24 age group the figure was 75% unemployed.
During 2010/11 the Calderdale Probation Service supervised 1236 offenders; 936 on Community Orders and the remainder in custody or on licence in the community.
Our national assessment tool, OASys (used by the Prison Service too) indicates that over 2010/11 Calderdale had the highest percentage of assessed cases where alcohol misuse and drug misuse were identified as factors contributing to offending behaviour. 59% of assessed cases indicated alcohol misuse was a problem linked to offending.
The information below is taken from ‘A Health Needs Assessment of Offenders/Ex-Offenders in the Community in Leeds’ (December 2008). This report was commissioned by NHS Leeds in anticipation of a national Offender Health and Social Care Strategy (was due for publication in Spring 2009).
70% of the sample were smokers; 48% reported to have used illegal/prescribed drugs; drug and alcohol problems greater than current disclosure; access to dental services and mental health services problematic; “overall, the findings indicate that offender health is significantly worse than the general population”.
For information on substance misuse in the general Calderdale population please see the Substance Misuse section
Mortality rates amongst offenders
Community offenders are 4 times more likely to die than the general male population, a rate that is twice as high as that of imprisoned offenders (Sattar 2001). Drugs and alcohol were related to around 46% of deaths of community offenders. Half of offender deaths occurred within 12 weeks of release.
Clear links between poor health and criminal behaviour
Skeem and Louden 2006, found that offenders with serious mental illness are twice as likely to fail in community supervision as those without mental health illness. Re-offending rates also positively correlate with poor health status (Social Exclusion Unit 2002) and MDOs out of contact with services can be particularly at risk of re-offending (SEU 2004).
A Socially Excluded Group
Experiencing worse health, difficulty in accessing necessary services (Department of Health) Mair & May’s (1997) comprehensive interviewing of a sample of 1213 people on Probation caseloads included questions relating to health status. 49% of the sample reported having, or expecting to have, a health problem lasting at least 6 months: this is higher than the general population. For example, 46% of the male probationers aged 16-44 years reported long-term illness or a disability compared with 26% in a matched age group within the general population
Disability and Learning Difficulties
A snapshot of our caseload of 1046, at July 2011, identified:
- 35 individuals with dyslexia or a learning difficulty.
- 24 with a mental illness.
- 7 with hearing difficulties.
- 29 with “other disability”.
It is very likely that the figures above under-estimate the true range and significance of disabilities amongst our caseload.
Consistent messages from the literature on women offenders include the following:
- Women offenders tend to have a history of unmet needs in relation to education, training and employment, health (including mental health), housing and income
- Their sexual and violent victimisation can play a part in the onset and persistence of offending
- Research indicates high rates of substance misuse, especially opiates, amongst female offenders
- Women’s offending is most often associated with poverty and financial difficulties
- Many women’s financial situations are further strained by their having sole responsibility for dependent children
Women offenders have a different profile of risks and needs than male offenders, including:
- Women offenders tend to be convicted for less serious offences – 44% of women prosecuted were for theft and handling offences compared to 28% of men
- They also tend to have multiple and therefore more complex problems related to their offending – 26 per cent of women reported having been treated or counselled for a mental health or emotional problem in the year before custody, compared with 16 per cent of men
- Of the women reporting an alcohol problem, nearly three quarters (74%) also have a drug problem. Among men with alcohol problems entering local prisons, just under half (48%) also reported a drug problem
- Over half of the women in prison report having suffered domestic violence and one in three has experienced sexual abuse