Transforming delivery of substance misuse support to female prisoners

First published: 09 May 2019 | Last updated: 20 May 2019

Miss Alex Viccars

The Forward Trust

Aims, Design & Setting:

In response to an external service evaluation of the substance misuse service at HMP Send, a new model was designed to increase accessibility of substance misuse treatment and provide a range of interventions suitable for women with different needs. The service re-design aimed to explore whether a flexible, needs-led model of substance misuse support would improve treatment outcomes for female prisoners.


135 women who engaged with the ‘Levels’ model from 01.09.16 to 31.08.17 were compared with 138 women accessing treatment in the 12 months prior.


The range of interventions offered within the Levels model are outlined below:


Psychometrics measuring pre- and post-programme motivation to change, confidence in abstaining from drugs and alcohol and social problem solving skills were collected using:

  •  University of Rhode Island Change Assessment
  •  Drug Taking Confidence Questionnaire
  •  Social Problem Solving Skills Inventory

Findings & Conclusions:

  • 95% completion rate for Stepping Stones and 25% increase in completion rate for Footsteps in Recovery. Improvements were also shown in participants ‘ motivation to change substance misusing behaviour, and confidence in abstaining from drugs and alcohol.
  • 12% increase in number of clients receiving clinical interventions
  • 120% Increase in the number of clients completing a detox
  • 88 decrease in the number of missed appointments
  • 27% increase in clients accessing community treatment upon release

These findings show that a flexible, staged approach to prison-based substance misuse support can prepare women for intensive treatment, meet their needs more effectively and lead to improved treatment outcomes.


Ms Hattie Moyes MSc: Research Manager, The Forward Trust Miss Alex Viccars BSc: Senior Research Officer, The Forward Trust

Conflicts of interest:

no conflict of interest


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Miss Alex Viccars