40 Days in Mayfield Women’s Prison; Chapter 16 Her Majesty’s Inspectorate of Prisons Report into Mayfield Prison Extract 8

Substance Misuse

Women with drug and or alcohol problems are identified at reception and receive effective treatment and support throughout their stay in custody.

Women were less satisfied in our survey than the comparator when asked about the support they received regarding substance misuse. Clinical and psychosocial care was very good and the range of interventions was comprehensive, catering for a wide range of needs. The substance misuse recovery unit provided women with support in a well-managed environment on the first night.  The women were also helped with stabilisation and ongoing recovery. Women’s failure to attend clinical reviews was a cause for concern.

Clinical and psychosocial substance misuse services were delivered by a subsidiary of Paratech. In our survey, fewer than the comparator said they had received support for drug or alcohol problems. Of those who had received support, fewer than the comparator, 69 per cent against 80 per cent said they had found the support helpful.

Nevertheless, the range of psychosocial interventions was comprehensive, catering for a wide range of needs. One to one work was complemented by group work. In addition to a drugs awareness course, which included a focus on new psychoactive substances. These new drugs mimic the effects of illegal drugs such as cannabis, heroin or amphetamines and may have unpredictable and life-threatening effects. There was a good range of mutual aid groups. They included Alcoholics Anonymous, Narcotics Anonymous and self-management and recovery training. Three peer supporters, who were women who had been trained, delivered regular support groups, facilitated awareness sessions and provided one to one support. Some women said this was invaluable.

Following prompt screening and treatment on arrival, women with clinical substance use needs were transferred to the first night spur in the substance misuse recovery unit in H block 1 for their first night. This unit had 24-hour nursing cover and officers completed an extra 6 log observations on women’s first night.

Methadone administration was conducted satisfactorily in the unit and good supervision was balanced with adequate privacy at the medication hatch.

Women were required to attend regular reviews to ensure their treatment remained appropriate, but too many women were not attending these meetings. Taking a sample of one month, 18 women did not attend their appointments. The women had been informed that non-attendance had implications for their continued treatment. If they continued to fail to attend, they had to undergo rapid detoxification for safety reasons. While this ultimate sanction was in line with national guidance, it was not often used. Several women had started attending the reviews after they were given an explanation of the need for these sessions.

Some women told us that the shortness of their sentences was the reason they did not attend reviews. To quote one woman, “I was living in a crack house, I breached my licence; I’m here for two weeks and then I’ll go back to the crack house. What’s the use of seeing the doctor or a drugs worker?”

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