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Transition Support for Ex-prisoners:Integrated Systems of Support

Professor Joe GraffamDirector, Centre for Mental Health and Wellbeing Research

Deputy Dean, Faculty of Health, Medicine, Nursing and Behavioural SciencesDeakin University

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Reintegration as an outcome of ecological conditions

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The Need for Transition Support Programsfor Ex-prisoners

Across jurisdictions, almost two-thirds of people in prison have been there at least once before. One-third re-offend leading to re-incarceration within two years of release. Two-thirds are unemployed at the time of re-offence. Approximately two-thirds have a Year 10 level of education or less. Many have ‘no fixed address’ at time of re-offence.

Released prisoners commonly experience multiple conditions of disadvantage including: mental ill-health; drug and/or alcohol dependency; chronic diseases and poor physical health; poverty; unstable housing; under employment; and social isolation. These conditions interact with each other and can change with little notice.

Transition support is needed to assist with successful reintegration within the community. The objective is sustained positive lifestyle change, a necessity if someone is to succeed within the community. Achieving this independently is unlikely, given pre-conditions. Comprehensive transition support programs are needed, and ‘one size’ definitely does not ‘fit all’. We need individualised, dynamic support programs.

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Lessons from “over a neighbour’s fence” There are lessons to be learned from what has been long-term profound

change within the disability services sector, internationally and nationally. For most of my research career, I have conducted, and still do conduct, research into community integration of people with a disability.

One of the early and most important contributors to this change was Marc Gold. He was a theorist-practitioner who has been influential in the evolution of disability thinking, policy and practice.

Gold identified what is known as the “competence-deviance hypothesis” which states that the more competent a person is, the more different they will be allowed to be. His approach was one of empowerment through competence.

Gold defined disability in systemic terms, stating “Mental retardation is the inability of society to adjust to the people who live within it.” By taking this position, he emphasised the need for service providers to pay at least as much attention to their own structures and practices, as well as community conditions, as the attention paid to building competencies of their clients.

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Lessons from “over a neighbour’s fence” The emphasis on building individual competencies through vocational

education and training, alcohol and drug treatment, mental health support, and other relevant intervention programs is obviously important. Provision of individual support programs would mean tailored, ongoing support that would facilitate re-integration within the community.

It is equally important to focus on the support services themselves. If an individual’s success is ‘inter-dependent’ and based on partnerships with (and among) support providers, then ensuring the quality, capacity, and effective delivery of support is essential. Service provider ‘inter-dependence’ is essential. Specific need based services must be able to interact effectively to best support their clients.

To me, ‘innovation through collaboration and inclusion’ is reflected in Integrated Local Systems of Support. These have formalised inter-dependent relationships and shared client bases. There are several elements or operating principles that should inform such programs.

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Operating Principle #1: Start with a program of sufficient scale

Many programs commence as ‘pilot’ programs, operating on a sub-optimal scale, and have difficulty achieving program objectives as a result. Such programs may even struggle to perform all necessary functions, also a result of sub-optimal funding or scale of operation.

Demands on program staff can be extensive and intensive when a small number of staff are required to fill a wide range of program functions. The requirements for multi-skilling and multi-tasking are substantially higher and more demanding with smaller programs. This issue is even more pronounced when the program target group has multiple, complex and/or dynamic support needs as do prisoners.

Transition support programs for people attempting lifestyle change should be designed and implemented to operate from the outset on a scale that supports the level of complexity and demand that can be expected, based on what is known about the support needs of the target group and the best way to address those needs (that is to say, via an integrated support system of networked providers).

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Operating Principle #2: Conduct thorough needs and risk analyses

There are resource needs and risks associated with every component of a proposed program and all relationships and resources upon which success of the program will depend.

A needs analysis and risk analysis should be conducted to avoid duplication of services and ensure demand for the program. A plan for managing risks should be developed prior to program commencement.

Related to this activity is compilation of a ‘portfolio of assets’, an inventory of people and resources already available to contribute to the program’s success locally.

An ‘asset development’ process should also be established which includes acquisition of expert staff, relevant training materials and other support materials, a suitable site from which to operate, and other relevant resources.

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Operating Principle #3: Conduct thorough network development

It is best to cover the multiple transition support needs of clients with complex support needs through a system of networked delivery rather than having one provider attempting to meet the full range of support needs characteristic of released prisoners or having to engage in laborious and recurrent referral activity.

Instead, prior to program commencement, an analysis of existing services should be conducted and formal agreements made to establish local networked service delivery. This requires commitment from all relevant service providers, positive working relations, excellent information exchange, and dedicated resources to maintain the network.

Contributing members of such a network can partially subsidise the network cost through savings resulting from increased or less effortful incoming referrals.

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Operating Principle #4: Market the whole program

Often, transition support programs are profiled as ‘specific purpose’ or ‘single purpose’ programs with ‘add ons’. It would be more advantageous to develop a comprehensive support program that includes a wide range of services, with no ‘lead’ element.

It is also important to present the program, within its place of business and in all of its business materials, as a personal and/or professional development program.

By recommending that the whole program be marketed, it is meant that the ‘innovative nature’ of the program should be promoted. The ‘morality’ of the program should be emphasised by making explicit the issue of multiple disadvantage experienced by the participant group, as well as the issue of restorative justice.

The socio-economic advantages should be pointed out in marketing the program within a local community. There are benefits that a transition support program can provide to the community and should be communicated as such.

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Operating Principle #5: Focus on the capacity building function

There is also a capacity building function to a transition support program for people exiting the justice system. This should be articulated as part of the program’s profile and in promoting the program. Capacity building objectives and goals should be articulated as program objectives and goals, tracked, and reported accordingly.

Some capacity building outcomes of transitions support programs should be: formation of a local network of delivery through an integrated support service systems; improved communication among service providers; growth of relevant service providers through improved referrals; provision of mentor training to members of the community; and possible development of new/additional services to fill identified service gaps.

Any aspect of the program that can contribute to strengthening or adding capacity to the community or to the service environment within the community should be included in the analysis of the capacity building function of the program.

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Operating Principle #6: Adopt an ecological systems model

An ecological system is a ‘living system’. It is a system that sustains life, and it also has a life of its own. Ecological systems are dynamic, changing systems comprised of a multitude of inter-related, inter-dependent, and interactive elements.

Communities are large ecological systems, macrocosms; we manage, manipulate, act, react, and adapt to the conditions around us. We are interactive agents within those systems. An individual’s environment is a smaller ecological system, a microcosm of elements: Intra-personal; Inter-personal; Material; Community; and Society.

Community reintegration is best understood as ecological system engagement; the compatibility of a person’s resources and needs and conditions within their living environment. A healthy ‘match’ is promotive of positive lifestyle change.

As conditions change, compatibility can improve or worsen. Support services must be sustainably, rapidly responsive. Reintegration is a process, not an event.

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Operating Principle #7: Adopt ‘reintegration’ as the core principle

Rehabilitation models tend to be focused on addressing individual character defects and skill deficits. They are program-oriented, measuring ‘success’ in terms of program goals, not on real world context-oriented success in vivo. Rehabilitation can be an important element of support, but not sufficient, in and of itself.

Desistance models are currently popular, but desistance is difficult to measure and narrow in focus. Simply focusing on desistance does nothing to address issues of multiple disadvantage and the long term detriments of many of those conditions.

Reintegration models have a focus on ‘people in context’; whole people and the context within which they live and strive to succeed. Resources, needs and environmental conditions are the basic concepts.

The objective of a reintegration model is sustained positive lifestyle change for prisoners. To achieve this objective: increase the emphasis on transition support as the core program purpose; a wide range of target outcomes should be included ; lengthen transition support eligibility time; provide a whole of government response .

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Operating Principle #8: Develop a system of integrated support

The most effective way of achieving effective transition support that provides sustainable, positive lifestyle change for people with complex support needs is through an integrated local support system of networked providers. This is best achieved with formalised inter-relationships.

At the core of the network would be a Transition Support Program (TSP) responsible for coordination of the network, case management of individual support plans, relationship management pertinent to networked providers, and crisis intervention (short term support for clients in crisis for any reason).

Elements of an integrated local system of networked support will include: health services; housing services; employment services; drug and alcohol treatment; personal and family counseling; and access to vocational training and education provision, as examples. This model includes four fundamental elements: analysis and mapping of individual resources and support needs; implementation of a comprehensive transition support plan; access to all relevant support services; responsiveness to emergent needs of individual clients.

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An Integrated System of Supports

Employment

Health Housing

Education and Training ?

Social Network

Finance Drug and Alcohol

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An Individual Support Program

1. Analysis of individual resources and support needs.

2. A comprehensive and individualised support plan.

3. Access and engagement with all relevant support services.

4. Communication and exchange of information.

5. Regularity of contact (case management).

6. Recognition of the dynamic and interactive nature of conditions and the need for responsive support.

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An approach to integrated support

1. Start with a program of sufficient scale.

2. Conduct a thorough needs and risk analyses.

3. Conduct thorough network development.

4. Market the whole program.

5. Focus on the capacity building function.

6. Adopt an ecological systems model.

7. Adopt ‘reintegration’ as the core principle.

8. Develop a system of integrated support.

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An approach to integrated support

. . . Oh, and don’t forget to learn from neighbours

‘over the fence’.