This is an edited book that provides a predominantly British overview of the management of substance misuse and mental health problems in the criminal justice system, particularly around community disposals. For an edited book, the themes are consistent and coherent and a number of critical themes emerge that are of interest well beyond the development of UK policy and practice – these include the challenges and inconsistencies of risk and rehabilitation models; the attempts at reconciling therapeutic and policing functions in the management of vulnerable and complex offenders in the criminal justice system; the measurement of rehabilitative outcomes for commissioners and policy makers; and the role of professionals and therapeutic interventions in supporting and enabling long-term rehabilitative objectives. The book is highly informative and extremely useful as an account of one country's evolution of criminal justice processing at a time where the multiple risks and vulnerabilities of criminal justice populations are increasingly recognised if not adequately addressed. But the overarching themes of the book are so much richer in framing the complexities of operationalising a rehabilitative model with a complex cohort of offenders whose wellbeing is likely to be further compromised by incarceration.
The core tension is that the transition to a risk model – designed to protect the interests not only of the offender/drug user/mentally ill person but also of the wider society is inherently both actuarial and conservative. Thus, it is predicated on the idea that assessment will identify likelihood of re-offending or relapse, and if this poses significant public risk, it is in the interests of ‘society’ that this risk is ‘managed’ by removing the individual. With the deinstitutionalisation of mental health treatment, this increasingly means via the criminal justice system and prison, in particular. As Clift argues in Chapter 2 of the book, the application of this model affects not only the management of individuals but the structuring of services and the establishment of targets for publicly funded services. One consequence of this risk averse strategy has been the burgeoning growth of the prison population in the UK (supplemented by another controlled cohort on a range of community orders), and in the drug treatment world managed by the National Treatment Agency in England, a series of goals in the first decade of the millennium, that set engagement in treatment as a laudable outcome, irrespective of the quality of that treatment.
What makes this book so fascinating is that this model of actuarial risk management is juxtaposed against the rehabilitative model with all of the ramifications for personal choice, self-determination and what in the criminal justice system is increasingly referred to as ‘therapeutic jurisprudence’. In Chapter 9, van Wormer and Starks outline therapeutic jurisprudence as a model promoting institutions of justice as capable of producing therapeutic outcomes – ‘the role that adjudication might play as a therapeutic agent in helping people in trouble with the law become productive citizens’ (van Wormer & Starks, Citation2012, p. 153). Not only does this require a dramatic change in the culture of criminal justice agencies, it is predicated on a model of change that is fundamentally optimistic and positive.
Thus, even for the readers with no interest or involvement in the criminal justice system, the debate around risk and rehabilitation is a remarkable parallel to the evolution of the recovery model in the UK. The ‘good lives’ model promoted by Ward and Maruna (Citation2007) for rehabilitation of offenders bears a remarkable resemblance to the recovery model – they are developmental approaches based on hope, social connection and a viable and active stake in their own community. Indeed, in Chapter 10, Pycroft talks of ‘eudaimonism’ as the rehabilitative ideal – the living of the good life. This is at heart a model based on normalisation – that recovery/rehabilitation is about everyday goals and being what you can be, not about the reversal of symptoms or illnesses.
And here is the rub and the problem. This fundamentally shifts the role of the professional – they are not centre stage (at least not for long in the recovery/rehabilitation odyssey) and, every bit as crucially, they are not the judges or arbiters of whether someone is recovered or rehabilitated. Irrespective of the quality of the tools at their disposal, the role of the professional in the Recovery Movie can hope for Best Supporting Actor awards at most – the Best Actor award is reserved for the person in recovery. And this is where, in spite of policies in Scotland and England, and the remarkable volte face affected by the NTA, policy makers have a problem. We have no adequate test for ‘measuring’ recovery states so the temptation is to fall back on the risk management methods for assessing effectiveness of interventions.
The force of the recovery/rehabilitation arguments in mental health, criminal justice and alcohol and drugs are gathering momentum and sharing lessons and experiences, but our relationship to public policy and goal setting is fraught and challenging. ‘Risk and rehabilitation’ is a thoughtful, considered and nuanced discussion of some of these fundamental arguments that are every bit as applicable to addiction policy as to criminal justice, and as such I strongly commend it to you.
David Best
Turning Point Alcohol and Drug Centre
Monash University, Victoria
Australia
Email: [email protected]
References
- van Wormer K, Starks S. Therapeutic jurisprudence, drug courts and mental health courts: The US experience. Risk and rehabilitation, A Pycroft, S Clift. Policy Press, Bristol 2012; 153–174
- Ward T, Maruna S. Rehabilitation. Routledge, Abingdon, Oxon 2007