Title: Gateway: A randomised control trial, economic and qualitative evaluation to examine the effectiveness of an out-of-court community-based Gateway intervention programme aimed at improving health and well-being for youth offenders; victim satisfaction and reducing recidivism
Funder: Department of Health and Social Care

Abstract: Background: Young adult offenders represent a vulnerable population with a range of complex and overlapping needs, such as mental health issues, substance misuse and difficulties securing accommodation and employment. The Harris Review on self-inflicted deaths in custody amongst 18-24 year-olds (2015) calls for more to be done to divert young adults from entering the criminal justice system, as well as increased availability of child and adolescent mental health services, and earlier prevention in the community. Despite an increased acknowledgement of the role of out-of-court community based interventions (OCBIs) and diversion, and their impact on the health and well-being of young adult offenders, the evidence base is still underdeveloped. Furthermore, there is a need to examine the potential cost savings, with the current social and economic costs of youth offenders in England being estimated at around £19 billion a year. Study design: The proposed study is a single-site pragmatic randomised controlled trial, which uses mixed methods, including embedded economic and qualitative evaluations. The aim of the study is to examine the effectiveness of an OCBI known as‘ Gateway’ on improving health and well-being of offenders aged 18-24, as well as reducing recidivism and improving victim satisfaction. Approximately 334 participants from Southampton will be assessed at four time points over a two-year period for changes in mental health and well-being (primary outcome), as well as quality of life, alcohol and drug use, resource use and recidivism (secondary outcomes). The Gateway programme is a police-led and funded intervention, with a multi-agency approach. It aims to engage it’s participants with specialised health and social care services, and incorporates two workshops focusing on understanding offending behaviour, developing empathy and addressing the wider determinants of reoffending, such as substance misuse and housing problems. Impact of study: The results of this study will inform practice of relevant services and agencies, and add to the knowledge base on diversion initiatives. The evidence on the programme’s cost-effectiveness, and barriers and facilitators to its implementation will be used to improve the Gateway intervention, as well as in designing future similar initiatives, much needed by the young people themselves, their families and community, and society as a whole.

Lay abstract: Aims: The study aims to determine whether a new out-of-court programme, named Gateway, improves the health and wellbeing of young adult offenders aged 18-24, influences their chance of offending again, and improves victim satisfaction. Background: Young adult offenders commonly have a range of health and social needs, and are vulnerable to mental health problems. People who have committed a crime usually need to attend court and face convictions such as prison. However, many believe that more should be done to prevent young adults from entering prison in the first place. The Gateway programme has been developed by Hampshire Constabulary, in partnership with local community groups, with an aim to improve the life chances of young adult offenders. In the programme, a mentor assesses the needs of each person and develops a care pathway with referrals to healthcare or other services as required. The participants then attend two workshops on empathy and the causes and consequences of their behaviour. Such programmes are believed to not only improve the health and well-being of young offenders, but also reduce recurrent criminal behaviour. However, there is currently little information about the extent of this improvement. Design: This study will compare a group of young adult offenders taking part in the Gateway programme with a group who do not take part and are given a court conviction. Participants will be randomly allocated to either group using a computer program, and their progress will be followed up at different time points for two years. Specifically, differences in mental health and well-being, quality of life, criminal behaviour, access to health and social care and substance misuse will be studied. In addition, we will hold interviews with both the participants and those delivering the programme, as well as an economic evaluation. Some of the group allocated to Gateway will also be asked to take part in restorative justice, which is a meeting between the offender and the victim, and an opportunity to make amends for the crime. A number of victims will also be interviewed to explore their views on restorative justice and Gateway in general. Costs associated with Gateway will be compared with the costs of the standard route through the court. To understand what works, where and for whom, further interviews will be undertaken with groups delivering out of court disposals in other counties. Patient and Public Involvement: To develop the study design, groups of adult offenders previously engaged with the criminal justice system were consulted, and their views taken into consideration. One stated ‘It would have helped me at that age. I was in and out of prison about seven times when I was younger; nothing addressed the root of what was the matter.’ The groups will be consulted again at later dates to ensure that the study is acceptable and appropriate. A Public Participation Panel (PPP) will be established to ensure that the concerns and attitudes of the wider community are also represented. Dissemination: The study results will be presented in a formal report, as well as a short summary report, which will be written in an easily understandable format and made available to the general public. The study findings will also be shared with all partners involved in the study, as well as the offender and victim groups, the PPP, academics and policy-makers locally and nationally.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: MENTAL HEALTH