Prison To Rehab - Abbeycare

KEY TAKEAWAYS

A 12-week structured rehab programme
Involves direct transfer from prison
Is dependent on suitability of candidate decided by prison staff [1]

What Is Prison To Rehab?

	Prison To Rehab	Detox In Prison
Aims	Full rehab programme	Detox from substances
Type Of User Most Appropriate For	Requires professional therapy	Requires detox upon prison arrival

	AA Meetings In Prison	Rehab Instead Of Prison
Aims	Group support in prison	Reduce offending
Type Of User Most Appropriate For	Requires in-prison 12-step mutual aid meetings	Committing crimes due to addiction

Process Overview

Identifying Candidates

Prospective clients are identified as:

Those who are serving a sentence of over one year - this may apply to shorter sentences if there is time to complete an assessment
Those who have demonstrated motivation for abstinent recovery in prison by attending prison recovery initiatives
Those who are on a medically assisted treatment programme in prison
Being over 18 years old
Having tested negative for COVID-19

Prospective clients with mental health conditions, physical health conditions, or a history of sexual offences are reviewed on a case-by-case basis.

Rehab engagement managers identify prospective clients by:

Providing presentations to those in prison and staff every four months
Attending prison-run recovery hubs/ cafes and speaking to those in prison [1]

Referral

During referral, prison staff are required to:

Assess that a prison-to-rehab programme is the appropriate service for the individual's needs
Assess that the individual is ready for rehab
Provide the rehab with history of drug and alcohol abuse, physical health and mental health, and any COVID-19 symptoms
Inform local alcohol/ drug treatment services, social workers, GP's, and the Scottish Government Residential Rehabilitation Team

When an offender's eligibility has been established, prison staff will refer the case file to a rehab facility [1].

Rehab Assessment

A rehab assessment for prison to rehab changes by:

Exclusively being a face-to-face assessment instead of a phone/ video call assessment
Multiple assessments being completed before signing off on client suitability
Performing a risk assessment considering any violent criminal history
Prehab assessments focusing on prospective clients demonstrating motivation to get clean and desire to change
Periodic assessments occur every 2 months during prison stay to reassess programme suitability [1]

Transfer To Rehab

The transfer from prison to rehab is done immediately to prevent the client from contracting COVID-19 or gaining access to drugs or alcohol.

If an immediate transfer is impossible, rehabs perform a COVID-19 test upon arrival [1].

Rehab Programme

The rehab programme for individuals leaving prison is altered from a regular rehabilitation programme by:

Once a month, in-person meetings with a local authority provided key worker
Once a month, in-person meetings with assigned parole officer
Clothing and toiletries for use in rehab needing to be coordinated by rehab team or family
Contacting DWP to arrange benefits post-programme
Coordinating housing post-programme
Coordinating foodbank access post-programme
Money management/ financial planning may be offered in some prison to rehab programmes [2]

Read about ketamine rehab.

Rehab Preparation In Prison

Steps that an offender can take to prepare for an addiction recovery programme while still in prison are:

Researching the most appropriate treatment provider for personal needs - e.g, anger management provision, crisis intervention training, etc
Accessing counselling/ therapy in prison
Accessing in-prison detox/ maintenance medication as appropriate
Organising relevant documentation for prison transition

Prison To Rehab Duration

The duration of a prison-to-rehabilitation programme is pre-agreed to be 12 weeks, with changes to this timeframe being:

Lapses or relapses prolonging treatment
Comorbid HIV/AIDS, Hepatitis, or STIs prolonging treatment [3]
Client self discharge from treatment

Is Detox Provided In Prison To Rehab?

Detox is provided in a prison to rehab programme if the individual has been accessing drugs or alcohol in prison and is withdrawing on arrival in rehab.

Offender Treatment In Scotland Vs Rest Of UK

Country	Scotland	England And Wales	Northern Ireland
Type of treatment offered	Prison to rehab	Incentivised substance-free living units [3]	AD:EPT (Alcohol and Drugs: Empowering people through therapy) [4]

Funding

Government Funding

The prison applies for funding to the Scottish Prison Service, who assess candidate suitability and release funding as requested.

In 2021, the Scottish government pledged to reduce drug deaths and make improving pathways from prison to rehabilitation a priority [5].

Barriers to accessing prison to rehabilitation schemes:

Scotland's prisons are at highest capacity to date
The £540 million Scottish prisons budget required to fund prison capacity and staff required as well as addiction treatment clients [6]

NHS

In-prison healthcare staff will access NHS treatment for prisoners by:

Either registering to a new GP practice or informing the current practice of imminent release
Updating practice of care records from prison
Ensuring prescriptions are available for collection upon release
Informing GP about addiction status to ensure needs are met appropriately

An offender may access outpatient addiction treatment until an NHS-funded recovery programme is available, if the prison has decided that the individual does not require fast-tracking to rehab.

Health Insurance

Having a pre-existing health insurance policy typically means it is possible to access private addiction treatment.

Barriers to treatment are:

Taking out an insurance policy after leaving prison
Not having maintained insurance payments in prison
Having already accessed addiction treatment - typically, one treatment is available per policy

All factors depend on the policy provider's discretion; check directly with insurance providers.

Prison To Rehab Vs...

Outpatient Treatment

A prison key worker considers outpatient treatment more appropriate for:

Those appearing unprepared for the demands of a full rehab programme
History of relapse, self-discharge or non-compliance
Mental health status in prison indicating individual will not cope with stress of leaving prison and demands of rehabilitation environment [5]

Detox

In a small minority of circumstances, detox alone may be the most appropriate form of treatment:

First-time offenders with low psychological and physical addiction
Strong social support and community networks already in place outside of prison

Secondary Supervised Facilities

Secondary supervised facilities are the most appropriate form of treatment:

When detox has already been completed in prison, and the individual has continued to be sober
Long-term maintenance medication has already been implemented successfully, but therapy is still required to deal with underlying causes of addiction
The individual has no access to housing, or current housing has enablers and triggers of addiction

Pathway-Specific Treatment Experiences

One prison-to-rehab provider highlighted barriers during treatment as:

Leaving prison and entering another facility with restrictions
Inaccurate self-reporting of current drug use
Lack of motivation for abstinence
Lack of understanding of programme requirements [5]

Two treatment providers reported that individuals dropped out at the transfer stage due to not understanding the treatment programme.

Two providers reported that prisoners without bank accounts or IDs slowed the admissions process [5].

Rehabs do not track recidivism rates as part of recovery, and Abbeycare uses the same recovery star method for all clients.

When Is Prison To Rehab MOST Appropriate

Low-level risk of violence or sexual abuse indicated from previous offences [7]
Those who have experienced limited gains from community-based addiction treatment [5]
Has demonstrated consistent willingness to participate in the recovery programme throughout time in prison
Access to a stable home environment without enablers after treatment
Access to a supportive community environment with limited triggers after treatment
Low risk of reoffending - active family and community support systems, limited criminal history, and limited substance abuse [8]

When Is Prison To Rehab NOT Appropriate

High-level risk of violence or sexual abuse indicated from previous sentences [7]
Have previously benefitted from/ have not experienced community-based addiction treatment [5]
Inconsistently demonstrated willingness to participate in the programme throughout time in prison
Surrounded by enablers in home environment
Lack of supportive community environment with extensive triggers
High risk of reoffending - lack of family or community support systems, extensive criminal history, and extensive substance abuse [8]

What Prison To Rehab Is NOT

A guarantee of never returning to rehab or prison
Appropriate for all forms of addiction - e.g. Abbeycare does not offer treatment for gambling as a primary addiction
Involuntary - it is illegal in the UK to admit an individual to sobriety treatment without consent [9]
A guarantee that offenders take accountability for actions - e.g. Abbeycare's treatment programme focuses on taking responsibility for addiction and remaining sober
Standalone intervention for addiction - accessing appropriate aftercare is a crucial step in the recovery journey

(Read about hippy crack addiction.)

The Prison To Rehab Programme At Abbeycare

The prison-to-rehab programme at Abbeycare includes:

Transfer directly from prison
Detox if appropriate
A full 12-week treatment programme
Liaison with appropriate assistance with employment, support groups, and housing assistance [1]

Call 01603 513 091 for an initial assessment at Abbeycare.

References

[1] Scottish Government. "Prison Release - Residential Rehab: Procedure (for staff)." Scottish Government, 2022. "Prison staff involved in the delivery of treatment of drug and alcohol conditions should be involved in active preparation with the prisoner to identify the most suitable residential service."
[2] HM Chief Inspector of Prisons. "Written evidence from HM Chief Inspector of Prisons, HM Inspectorate of Prisons (TRH0117)." HM Inspectorate of Prisons, 2018. "Prisons which demonstrated good practice in helping prisoners open bank accounts, actively set up arrangements with banks and creditors and ensured that staff were available to assist prisoners in opening accounts. Further, these prisons enabled access to specialist benefits advisers and offered money management courses to prisoners."
[3] British Association of Sexual Health and HIV. August 2023 Standards for the Management of Sexual Health in UK Prisons British Association of Sexual Health and HIV 2 Standards for the Management of Sexual Health in UK Prisons. 2023. “People in prison being tested for STIs should have access to the most appropriate diagnostic tests. All diagnostic samples should be processed by laboratories in a timely fashion in order that results can be conveyed quickly and acted on appropriately. Robust processes should be in place to ensure timely transit of samples to the laboratory. Governance pathways should be developed to ensure all results are appropriately acted on. People in prisons should have recourse to access their own results.”
[4] Department of Justice. “Substance Misuse | Department of Justice.” Justice NI Gov UK, 11 Sept. 2015. “AD:EPT (Alcohol and Drugs: Empowering people through therapy) drug and alcohol service is delivered by Opportunity Youth across the 3 sites of NIPS and in partnership with the South Eastern Health and Social Care Trust. AD:EPT is a comprehensive drug and alcohol service providing a range of services to people in custody who have problems associated with the misuse of substances.”
[5] Scottish Government. Prison to Rehab Pathway Health & Social Care Analysis. 2021. “Given the high prevalence of drug dependence among Scotland’s prison population, the treatment pathway from prison to residential rehabilitation has been identified as a priority.”
[6] The Scottish Parliament, Criminal Justice Committee. "Pre-budget scrutiny of the Scottish Government's budget for 2025/26." Scottish Government, 25 Nov. 2024 "Table 2."
[7] UK Ministry Of Justice. "Guide to Proven Reoffending Statistics." UK Government, April 2019. "Indictable and summary offences – Proven reoffending statistics quarterly (published 28 July 2016) included a table (B1.1) on serious sexual/violent proven reoffences and serious acquisitive proven reoffences."
[8] Lowenkamp, Christopher T. "Understanding the Risk Principle: How and Why Correctional Interventions Can Harm Low-Risk Offenders." 2004. "Figure 1."
[9] UK Department Of Health. "Reference guide to consent for examination or treatment: Second edition." UK Government, July 2009. "It is a general legal and ethical principle that valid consent must be obtained before starting treatment or physical investigation, or providing personal care, for a person."