Final Report RAND Europe with research support from Rosie Meek, Kirsty Hudson, Sarah Senker and Charlotte Scott

RAND Europe was commissioned by the Ministry of Justice in 2022 to conduct a study exploring the lived experiences of two interventions in prisons in England and Wales: drug testing regimens and incentivised substance free living (ISFL) wings. Mandatory drug testing is routinely conducted in prisons to monitor drug trends, deter drug consumption (through sanctions), and identify individuals in need of further support. ISFLs are dedicated wings for prisoners who want to live in a drug-free environment, whether that be free from the consumption of drugs, the violence related to drugs, or the culture of drug use. Drug testing regimens and ISFLs feed into the delivery of His Majesty’s Prisons and Probation Service’s (HMPPS) drug policy for prisons, which is guided by three key aims: restrict supply, reduce demand and build recovery. This study aimed to understand how drug testing regimens are delivered, experienced, and perceived. Findings will shape the ISFL model by understanding the lived experience of staff and prisoners both on existing ISFL wings and elsewhere in the prison. Findings from this report will also be used to inform the design of a randomised controlled trial and process evaluation on ISFLs and a larger qualitative piece of work on implementation of drug testing. Data collection consisted of interviews and focus groups with prisoners, interviews with prison staff, and observations of drug testing suites and ISFL wings. Fieldwork took place in March and April 2023 in three prisons: a category C men’s prison in the North of England; a category B/C men’s prison in Wales; and a closed women’s prison in the South of England. Key findings on drug testing regimens Drug testing regimens appear to be designed with limited consideration of the variation and uniqueness of each prison and its population. The research identified practical limitations for prisoners on remand or serving short sentences in accessing support services. Female prisoners experienced the process of being tested as degrading due to the different way that they provide a sample in comparison to men. The illicit use of prescription medication, sourced through the prison’s medication hatch and traded among prisoners, was reported to be prevalent in all three sites. There was no immediate way for prison staff to know whether a positive result was the result of misuse or legitimate prescription use. The process for confirming this, via medical records, was described as lengthy and, at times, inappropriately punitive to prisoners legitimately taking prescription medication. Several staff and prisoners commented that the regimens were testing for substances that were widely understood not to be consumed in the sites. Drug testing regimens were not always seen to be effective as a therapeutic tool to support prisoners or address underlying needs that drive drug use. Generally, prisoners were either indifferent to, or supportive of, drug testing itself. The punitive responses to positive drug tests were felt to do little to deter drug use, in the absence of support being offered. Most participants, particularly in the men’s prisons, felt that drug testing was currently ineffective at deterring drug use in part due to inconsistent implementation. Additionally, for some at the South of England prison the ‘benefit’ of taking drugs to help deal with mental health issues and prison life, outweighed the ‘cost’ of getting caught. Key findings on ISFL wings There were mixed perceptions about the value of ISFL across the prison population. In the North of England and Welsh prisons, staff and prisoners were generally positive about the operation of the ISFL and attributed this to a calm atmosphere, positive and supportive relationships with staff and other prisoners, extended time out of cells and additional support services to help prisoners address their mental health needs. At the South of England prison, the ISFL was struggling to differentiate itself from other wings which staff and prisoners attributed to a lack of incentives specific to the ISFL. ISFLs were described by both staff and prisoners as having ‘a bad rep’ and creating ‘ill feeling’ among prisoners on other wings. This was put down to jealousy and resentment about the additional privileges and a perception that prisoners on ISFLs were colluding with management. ISFL referral processes differed significantly in implementation across the three prisons. All three wings used some form of referral criteria for recruiting participants. However, how referral worked in practice seemed ad hoc, informal and varied from site to site. The process for being able to reside on the wing was also unclear to many prisoners. Approaches to dealing with positive drug test results from ISFL residents also differed across the sites. In the North of England prison, a ‘two strikes’ approach to excluding prisoners from the wing appeared to be implemented consistently, while in the Welsh prison there was more flexibility for prisoners who volunteered information that they had used drugs. In the South of England prison no such penalty was applied. Talking therapies and purposeful activities were important in supporting recovery. The peer-led component of therapies and the opportunities to build supportive relationships with other residents through additional time out of cells and in shared spaces was felt to be effective in helping prisoners to understand the drivers of their drug use and how to address their mental health needs. The importance of a stable, safe environment and providing activities tailored to the needs of the population was highlighted by interviewees. Many believed that an ISFL should primarily be a settled environment where prisoners can access help to support their needs, and that a mix of prisoners, with and without histories of drug use, was beneficial in creating this environment. However, the environment in the ISFL at the South of England prison was described as ‘disruptive’ as it included prisoners who had not chosen to be on the ISFL, and other wings were described as offering a more therapeutic, communal environment. At this prison, staff also reported that the incentives on offer were typically more popular in a male, rather than female, prison (e.g., gym weights or pool tables) and female prisoners described different motivations for taking drugs. Findings underlined that the types of drugs consumed, reasons for drug consumption, and mental health and other needs vary by sex.

London: Ministry of Justice, 2024. 106p.

By Andrew Blum and Alfredo Malaret Baldo

The problem is as old as the justice system itself—how to reduce the chance that an individual reoffends

after they commit an offense and become involved with the justice system. This challenge of reducing

recidivism remains critical. According to the Prison Policy Initiative, there are over 120,000 individuals in

state prisons in California. Another 380,000 cycle through jails in California every year. In 2021, roughly

25,000 individuals were released from prison in California. This is the scope of the challenge. In San

Diego County, a wide variety of agencies and organizations are working to address the recidivism

challenge. In addition, although there is no way to measure this accurately, there is a willingness across

the spectrum to experiment with new approaches and solutions. This report focuses on one area of

relatively new and promising approaches—those that elevate the talent and expertise of individuals with

“lived experience” with the justice system. Support for lived experience approaches is growing both

nationally and in San Diego. Beyond the rising number of lived experience initiatives, this type of work in

San Diego has become largely normalized. There is broad agreement that lived experience work should

be part of the portfolio used to reduce recidivism, with clear demand from stakeholders involved in

reentry, including law enforcement officials, service providers, community members, and, crucially,

justice-involved individuals. Given the growing prevalence of and support for lived experience approaches

in San Diego, it is important to create a deeper understanding of how to increase the impact of these

approaches. Toward that end, this report identifies strengths of lived experience approaches to amplify,

challenges of lived experience approaches to mitigate, and lessons from lived experience approaches

that can be applied more broadly. Based on a review of the research and dozens of conversations held

with stakeholders in San Diego, we identified the following strengths of lived experience app roaches: —

They can engage successfully with justice-involved individuals; — They can provide a model of success;

— They are skilled navigators of the social service and justice systems; — They bring a long-term

approach to their work; and — They have specific expertise that helps them help others. To amplify these

strengths, we suggest: (a) deploy lived experience practitioners during acute situations, (b) leverage lived

experience practitioners not only within programs but also as navigators across programs, (c) build

flexibility into programs that include lived experience practitioners, (d) encourage lived experience

practitioners to role model success without being directive, and (e) continue efforts to normalize lived

experience approaches. We also identified challenges of lived experience approaches, particularly

related to scaling the approaches more widely. These include: — The personalistic nature of many lived

experience initiatives; — The difficulty of finding, vetting, hiring, and training sufficient lived experience

practitioners; — The toll the immersive nature of the work takes on practitioners; and — The potential

reputational risks lived experience approaches present to individuals, organizations, and agencies. To

mitigate these challenges, we recommend (a) creating training and certification programs for lived

experience practitioners, (b) developing standards of practice, (c) creating organizational capacity -

building initiatives for lived experience organizations, (d) pairing lived experience with non-lived-

experience practitioners, (e) treating lived experience individuals as professional staff, and (f) developing

a lived experience advocacy coalition. Furthermore, seeking a broader impact, we identified five key

lessons from lived experience approaches that are transferable and can be applied by those without lived

experience who are designing and implementing initiatives to prevent recidivism. The lessons are: 1.

Create supportive spaces for justice-involved individuals to work through challenges; 2. Design programs

with flexibility so support can be tailored to individuals; 3. Ease navigation of services and improve

coordination among providers; 4. Engage justice-involved individuals with consistency and long-term

vision; and 5. Commit to providing trauma-informed care. We conclude this report by noting the

longstanding good practice in the social services field to design initiatives with the input of those impacted

by them. The key lessons identified from lived experience practitioners can be viewed in this way. They

provide insight on how to design more effective recidivism reduction initiatives based on the experience

and expertise of those who previously lived the challenges the initiatives are designed to address.

San Diego: University of San Diego, Kroc School Institute for Peace and Justice, 2023. 31p..