Evaluation of Sixteen Women's Community Justice Services in Scotland

6 Holistic Support for Women

Key findings

• Practitioners in WCJSs provided or coordinated practical and emotional support for women in a number of ways, in addition to supervising the requirements of any community orders.
• Women most typically received support to stabilise their lives, link into appropriate services, and address practical, immediate issues prior to support related to longer-term change.
• Trusting relationships with worker(s) were a crucial factor in women's support in WCJSs. Women valued having 'someone to talk with', in addition to having practical support and an advocate with other services.
• Availability of support beyond the completion of an order was important for some women, but this raised concerns about service capacity.
• Women strongly desired or valued support for developing purposeful activities in their lives that they find rewarding and would help them to achieve their goals and 'move on'.
• Gender-specific, safe, informal environments created in WCJSs enabled women to connect with workers and other women in a way that many had not experienced in previous services or through supervision alone.
• Co-location or links with multi-disciplinary professionals lowered barriers for women accessing practical support and enabled genuine collaborative working across agencies, particularly where practitioners could make direct referrals, flexible appointments, and access information systems.
• Proactive outreach to where women live, having flexibility within orders (in terms of compliance and breach), and forming trusting relationships with women were important strategies in promoting women's motivation to engage with WCJSs.
• Women who disengaged from WCJSs were likely to be younger, have more previous convictions and more complex needs than those who successfully completed their time in WCJSs

Introduction

Firstly, this section describes the overall coordination of holistic support that women received in WCJSs through individual support, groupwork, and drop-ins. It describes key aspects of holistic support provided, including housing, welfare rights and finances, health, substance misuse, and purposeful activities (e.g. leisure work or training).

Secondly, this section includes features that were important to practitioners and women in how support was delivered in WCJSs, including engaging women into WCJSs, women's exit from WCJSs, women's relationships with workers and other women, the environment, and women's participation in service delivery.

6.1 In addition to supervising the requirements of women's community sentences (if any), WCJSs aimed to address those issues that bring women into and retain them in the criminal justice system. Existing evidence indicates that unless these underlying issues are addressed, it is unlikely that community sanctions or supervision alone will reduce reoffending.^[xi]

6.2 WCJSs varied in how they delivered support to women, depending on their capacity and characteristics (see section 3.5 and Table 1).

Coordinating holistic support

6.3 Many women entered WCJSs with complex needs. As emphasised in existing research,^[ix],[x] sequencing and timing of support is important; only once women have their immediate needs sorted and are stable and engaged, can practitioners and women work together to address longer term needs.

6.4 Not unexpectedly therefore, findings (Table 8) demonstrated that overall WCJSs prioritised support necessary to stabilise, engage and motivate women (e.g. support for emotional/mental health, problem solving, engagement with services and substance misuse) over support related to longer-term changes, such as developing positive or rewarding ways to spend their time, or links into the community (e.g. leisure activities, work, training), despite these being highly prevalent needs among women in WCJSs (refer back to Figure 2).

6.5 Table 8 shows the support received by women who entered and exited WCJSs between April and December 2014. When women entered WCJSs, practitioners recorded their presenting needs, and on exit, recorded the areas in which they had received support.

Table 8: Support women received in WCJSs by presenting need

Women who entered and exited WCJSs between 1 April and 31 December 2014 (194 women)

Note: Total percentages may not equal 100% due to rounding. Use of colour highlights order of prevalence.
√ Criminogenic need (associated with the risk of offending)

Notes: Practitioners could report multiple needs/focus. Data represents women who entered and exited WCJSs between 1 April and 31 December 2014, and who had presenting needs recorded on entry (194). Does not include women in Kilmarnock Court Action Note project or Highland WCJS. Women exited the WCJSs having been in the WCJSs from between 2 weeks and 8.5 months.

6.6 As indicated in Table 8, some women left WCJSs with unmet needs. This was more likely among those who had a shorter period in the service or did not engage well (see Box 10, after section 6.66 for a discussion of women who disengaged from WCJSs). In addition, needs may not have been addressed in WCJSs due to it being beyond the WCJS's scope or capacity (i.e. women may have exited to receive support in other services) or women may not be in the service beyond the time required to work on immediate needs only (see also exit from services section 6.58).

6.7 Women were most likely to exit WCJSs with unmet needs in purposeful activities (e.g. leisure activities, work, training), and to a lesser extent, their needs regarding housing, physical and sexual health (Table 8). Practitioners were very aware of the potential for duplication in a sector that involves multiple agencies and described efforts to address this, particularly at a case-management level (e.g. multi-agency action plans and meetings).

Individual support

6.8 All women in WCJSs had an allocated key worker or lead professional who provided or coordinated support and supervision (for those on orders). Some key workers were located outwith the WCJSs (e.g. in local CJSW team). The frequency of women's contact with their key worker varied according to need or stage of their order.

6.9 The individual support that women most valued was having 'someone to talk with', in addition to practical support (e.g. linking women into services, accompanying to appointments), and having an advocate or 'independent voice' for women with other services (e.g. GPs, welfare rights, housing, or in Child and Family case conferences).

6.10 Support for family relationships was provided in all WCJSs, delivered in multiple ways. More than half (57%) of women who presented with poor relationships with family members had received support in this area by the time they had exited services (Table 8). Groupwork activities focused on developing communication and interpersonal skills, and developing conflict management skills. Although some WCJSs ran 'parenting' classes, more commonly women received individual support related to their children, including advocacy at Children and Family case conferences. Support related to family was also closely linked to mental health activities such as trauma support or anger management skills. In addition, some WCJSs provided access to support via mentoring providers or third sector organisations such as Circle.

Groupwork

6.11 Groupwork (i.e. structured programmes) was delivered in 11 WCJSs by practitioners in-house and/or with external agencies (e.g. third sector partners). Participation was mandatory for some women subject to statutory orders.

6.12 The content of various structured groupwork activities delivered in WCJSs covered a range of topics aimed at addressing offending, its underlying causes, and developing broader life skills and experiences. Established groupwork programmes highlighted by practitioners and women included:

• Women moving forward, life skills and well-being programme (West Dunbartonshire) combines theory, practical activities, life skills, information sessions and short courses using a holistic welfare approach
• Connections programme (developed in Aberdeen, but delivered in multiple WCJSs including South Lanarkshire) to promote behavioural change, including emotion regulation, interpersonal skills and effects of offending.
• Survive and Thrive (Willow Centre and Forth Valley) and HOPE (TWG) to promote understanding of trauma and providing basic coping strategies.
• Abriachan Outdoor Programme (Highland) to experience activities that build confidence and life skills. Included SMART recovery work.

6.13 In addition to groupwork, several WCJSs included broader group activities, such as short community courses (e.g. first aid, food hygiene, gardening), newsletter groups, or charity campaigns. The aims were wide ranging, such as to foster women's interests or links in the community, improve mental health or confidence, develop pro-social skills, or involve women in shaping the service.

6.14 Many WCJSs were continuing to develop or enhance the content and delivery of groupwork and activities for women. Practitioners and women identified a range of elements that 'worked well' or that they still found a challenge, summarised in Table 21, Annex G. In particular, practitioners found groupwork had to be more flexible (e.g. shorter or rolling programmes to accommodate new women earlier).

'Drop-in' support

6.15 Drop-in services were provided in 11 WCJSs in an effort to minimise barriers for women in accessing support (see Box 6). Women and practitioners strongly valued the non-prescriptive, informal, holistic environment of drop-ins. Findings suggest that the availability of drop-ins contributed to women's improved engagement (section 7.20).

Box 6: 'Drop-in' support in WCJSs

Drop-in services provided ways for women to access holistic support. Drop-ins featured in eleven WCJSs, across all model types. Key features were:

• voluntary engagement
• opportunity to connect with others over a simple lunch, cup of tea, or activities with other women and workers
• low pressure, non-prescriptive activities e.g. arts and crafts, preparing lunch, therapeutic activities, discussions
• access to multi-disciplinary support from practitioners in attendance at the drop-in session (e.g. nurse, housing or welfare officers) or workers arranged an appointment or referral.

WCJSs had two main (overlapping) approaches to 'drop-ins':

• Designated sessions: Eight WCJSs had weekly or fortnightly sessions (2-4 hours) from locations in the community ('hubs'), CJSW premises or centre. Two WCJSs held sessions in third sector premises rather than CJSW buildings.
• Open for women anytime: Women could potentially 'drop in' to WCJS centres or CJSW premises anytime during business hours, which some did. However, due to the limited capacity of staff to be available 'round the clock', women mostly attended for planned appointments or activities and interacted with others in common spaces before or after their primary reason for attending.

Many WCJSs were continuing to develop their approach to drop-ins, such as how they might introduce more structure or groupwork, and strategies to respond to women who arrived unplanned or in crisis.

Housing support

6.16 Two in five women (39%)^[34] entered WCJSs with a housing-related need. The types of housing support for women included assistance to secure housing (e.g. advice on options, help with applications or securing deposits, advocacy) and/or support to address practical issues in existing housing with landlords or providers (e.g. securing new locks for safety, or addressing chronic dampness). Where women had 'sticky reputations' (e.g. relating to anti-social behaviour or substance misuse) WCJS staff provided contextual information on previous failed tenancies, domestic abuse situations or rent arrears in an advocacy role, to help women secure accommodation.

6.17 Across the WCJSs, various workers were involved in housing issues (e.g. housing and welfare rights officers in WCJSs, local authority housing teams, key workers, mentors, and third sector agencies).

6.18 Two WCJSs, in TWG and Fife, had dedicated housing officers co-located in their team. A higher proportion (60%) of women in TWG entered with housing needs compared to the average for all WCJSs (39%). This may reflect constraints in local housing provision, and/or their target group of women with high/complex needs (including a greater proportion of women leaving prison), which compounded the housing issues women faced (e.g. ability to liaise effectively with housing organisations; ability to maintain a tenancy due to addictions, anti-social behaviour, and debt; and removal from housing waiting lists when tenancies are not sustained).

6.19 In other areas, WCJSs predominantly referred women to external services or teams; this worked best when WCJSs had a named contact person to work with. A few WCJSs wished to develop stronger links with housing services, although others reported positive relationships and quick responses in their locality.

6.20 Data indicated that approximately a third of women exited WCJSs without receiving support for a housing need (see Table 8 above), despite that housing was an area in which women typically made progress (see outcomes section 7, Table 11). Several reasons may have contributed to the apparent unaddressed housing needs, including that few WCJSs had dedicated housing officers and therefore support received from external (housing) agencies may be under-reported. In addition, not all women who had housing issues were homeless, which may have reduced its priority relative to women's other needs. Practitioners also described that some unsafe or unstable housing issues were due to domestic abuse situations, which involve complex decisions for women and other types of support (e.g. for family relationships, emotional/mental health, engagement with services such as Women's Aid) before housing can be addressed directly. Some areas reported a housing shortage, which was largely outside the control of practitioners.

Welfare rights and financial support

6.21 Two in five women (39%)^[35] entered WCJSs with a finance-related need. Practitioners described money issues as particularly acute among women subject to benefit sanctions^[36] or on leaving prison.

6.22 It was standard practice for women to receive a financial assessment from social workers located in CJSW (often at report-writing stage) to ensure they received full and appropriate benefit entitlements. Typically, women received basic benefits support from workers and if needed, were helped in accessing welfare services (e.g. from local authority welfare rights officers (WROs)). Some WCJSs had links with independent money advisory organisations, such as Money Advice Scotland or Money Matters, which received referrals and/or delivered support through in-house clinics or groupwork sessions.

6.23 WROs (and in some WCJSs, the housing officer) also provided broader assistance with housing benefits, rent arrears and fuel debts.

6.24 WROs were co-located in women's teams in Dundee and North Lanarkshire (see Box 7). Practitioners felt this considerably enhanced the support for women. They also observed that changes to benefit rules and sentencing of social security fraud had disproportionately affected women because they were typically the claimants in households, and for some, issues were compounded by domestic abuse. These observations align to findings in a recent Clinks report that highlighted the gendered impact of changes to the welfare system.^[xii]

Box 7: Welfare rights officers (WROs) in WCJSs

Rationale for welfare rights officers

Practitioners in Dundee and North Lanarkshire strongly advocated that having a WRO co-located (at least part-time) in the WCJS made a 'huge difference' to addressing a previously unmet need among women:

"We went through a spell where we had quite a lot of women every week who'd been sanctioned. If they'd turned up late for an appointment with triage or whoever, their money was cut off. They were all coming in really upset and [the welfare rights officer] was able to see them literally straightaway, and get them to apply for another benefit."
- Practitioner, WCJS Women's Team

Previously practitioners felt they did their best to help women sort out benefit issues, however, they and women found the benefit system complex and time-consuming to navigate. Poor literacy, IT skills and access to a phone or internet posed additional challenges to women pursuing this help independently:

"I can't do forms. I normally get my drug and alcohol team to help me out to do that because I can't do it. You have to go to the… what's that place called? Citizens Advice, and it's not open all the time. So, if we've got people who know what they are doing, then it is handy, because I can't work a computer and I'm twenty-eight. Most twenty eight year olds can, but I can't. I get my daughter to do it."
- Shona (20s), service user

Activities of a welfare rights officer

Having a co-located WRO meant workers could hand relevant issues over to the WRO, who was better equipped to 'navigate the system' more efficiently, given their knowledge of terminology, procedures and current legislation. WROs acted as advocates at appeals and tribunals, and worked with women to access backdated money, rapid reclaims, emergency grants (for women on sanctions), as well as provide practical support and advice to claim the right benefit and avoid overpayments.

Crucially, WROs also had the professional and legal rights to act on women's behalf to progress a woman's case with the Department of Work and Pensions (DWP). Social workers had limited powers to discuss individual cases with DWP and so previously felt restricted in the support they could provide women.

Both WCJSs described high demand for welfare rights support from women and were planning to sustain or extend the WRO role.

Health support

6.25 The extent of provision for women's health varied widely, from WCJSs in which a women's worker assessed basic health needs and coordinated support with external services; through to women's centres with multiple health professionals such as the Willow Centre (a joint CJSW-NHS partnership with a focus on reducing health inequalities). The project in Forth Valley introduced a Criminal Justice Link Nurse to deliver support to women (e.g. in drop-in sessions) in existing women's services across three local authorities, offering a collaborative approach to providing mental health services.

6.26 Half of WCJSs^[37] had at least one full or part-time health professional in the team, such as a community mental health or psychiatric nurse (CPN), occupational therapist, psychologist, or addictions worker. Many health professionals had experience across multiple fields and could offer aspects of support in physical, sexual, and mental health and addictions.

6.27 Women in WCJSs represent a patient group often considered 'hard to reach'. The co-location of health professionals in WCJSs' informal environment, and practical support from workers (with whom women had trusting relationships) reduced barriers to women's engagement with health services. This suggests that WCJSs' holistic approach may be an effective (and therefore potentially cost-efficient) option to better meeting the health needs of this patient group, compared to traditional access routes, but this would require further research to confirm this.

6.28 Women's engagement with mainstream health services was most facilitated by:

• Co-located health professionals: WCJSs with co-located NHS-employed health professionals (full or part time) had access to patient information systems, could make direct referrals, be copied into appointment letters, and undertake preparatory work with women in WCJSs (e.g. psychiatric services):

"[…] you will say, "I wonder if they've attended substance misuse this morning". [The NHS team nurse] can just immediately go on and check that. I honestly don't know how we were able to support women who have got really poor health and addiction issues without having that information before, because it's so essential."
- Team Manager, WCJS Community Hubs

Where co-located health professionals were not NHS employees, these structural barriers affected their ability to link women into specialist support (e.g. access to information through NHS IT systems, 'gatekeeping' by services).

• Assistance to attend appointments: Workers supported women to attend mainstream health services for treatment or on-going support (e.g. GPs, dentists, mental health services, counseling, and addiction services). Practitioners provided practical help or encouragement for women to arrange or attend appointments (e.g. provided transport, reminded women of appointments), advocated for care on women's behalf (e.g. letters to GPs), or accompanied women to appointments to support them to communicate their circumstances or needs.

Physical and sexual health

6.29 Almost one third (30%) of women had physical or sexual health needs when they entered WCJSs (though sexual health was likely underreported (see section 4.11).^[38]

6.30 WCJS practitioners referred and actively supported women to attend mainstream health services, and/or offered nurse clinics for women (run by a team nurse or external agency, e.g. Keep Well Nurses).

6.31 Nurse clinics offered women physical and sexual health advice and checks (e.g. for pregnancy, contraception, blood-borne viruses). Practitioners in WCJSs with nurse clinics indicated that uptake from women was high. Clinics were voluntary, although it was routine practice for all women in the Willow Centre to meet with a nurse on entry, and in the Glen Isla Project, regular meetings with the team nurse were agreed as part of a woman's high tariff sentence in some cases. The team nurses in Dundee, Fife and the Glen Isla Project had the flexibility to do home visits.

6.32 Physical and sexual health information and advice was also included in components of groupwork and in conversations with women, enabled by WCJSs' informal centre or drop-in environments.

6.33 In general, practitioners identified physical exercise as an area for further development. A few WCJSs used community schemes for women to access to leisure centres or gyms, and the Abriachan outdoor programme in Highland included components of physical teamwork exercises. Plans for walking groups were underway in several WCJSs.

Mental health

6.34 Mental health was the most prevalent issue for women in WCJSs; over three-quarters of women (78%)^[39] entered WCJSs with a mental or emotional health need. It was also the area in which women were most likely to receive support while in WCJSs (Table 8).

6.35 Mental and emotional health needs covered a wide spectrum, ranging from poor self-esteem and feelings of isolation through to symptoms of complex trauma and long-term conditions (e.g. borderline personality disorder).

6.36 Practitioners and women identified that the interpersonal relationships, the trauma-informed environment (section 6.80), and a range of activities supported women's mental health in WCJSs, beyond those specifically labelled as 'mental health interventions' (e.g. group activities that reduced isolation and volunteer roles to build confidence). Therefore, all workers and women (e.g. as peers) had some role in promoting women's mental health in WCJSs.

6.37 With this in mind, activities to support women's mental or emotional health included (but were not limited to):

• Support from key workers and nurses: Workers offered women someone to talk to and strategies to improve mental health issues such as self-esteem, or anxiety (e.g. relaxation techniques, mindfulness).
• Groupwork: Components included information and techniques for managing mental health (e.g. stress, anger management, mentalisation). Several WCJSs included trauma-focused groupwork (e.g. Survive and Thrive in Forth Valley) (see section 6.12).
• Clinical therapies: TWG and Willow centres had team psychologists. Women received full mental health assessments and some received specialist therapies they wouldn't otherwise access through a GP, such as Cognitive Behavioural Therapy (CBT) and psychotherapy.^[40]

Substance misuse support

6.38 Three in five women (59%)^[41] entered WCJSs with a substance misuse issue. Support for addictions was a priority and likely to be provided while women were in WCJSs (see Table 8), as practitioners reported that without stabilising women's addictions, it was difficult to achieve progress elsewhere in their lives.

6.39 The mode of delivery for substance misuse support in WCJSs varied. North Lanarkshire's WCJS introduced an addictions worker in their new multi-disciplinary CJSW team (who was also a CPN). Several WCJSs employed health professionals with backgrounds in addictions services. TWG, a voluntary-only service which made a conscious decision not to include an addictions worker (with a means to prescribe treatments) to avoid women engaging under a compulsion to access prescriptions. In Highland, the women's social worker was located within the newly formed Substance Misuse Team.

6.40 Within WCJSs, the types of support offered included key worker or mentoring support, and help to attend appointments. Groupwork programmes included components on substance misuse. In Dundee, Fife and Angus, nurses delivered Naloxone training to staff, women and their families.

6.41 However, predominantly women were referred and supported to attend external addictions services in CJSW, NHS, or third sector agencies (e.g. DTTO teams, Throughcare Addiction Services, Integrated Addiction Teams, Addaction, and Turning Point). Health practitioners co-located from these agencies and/or with professional backgrounds in addictions maintained good links into substance misuse services.

6.42 Co-located health or addictions practitioners in WCJSs were also able to work with women to stabilise dual or complex needs and assess women for referral on behalf of addiction services (where they had direct links). This suggests potential benefits for external addiction services when their clients are ready, prepared, stabilised, and have emotional and practical support (e.g. reminders of appointments) from workers in WCJSs. In more detail:

• NHS nurses co-located in Fife WCJS and Glen Isla Project's multi-disciplinary teams were able to complete preparatory work (e.g. assessments or inductions) on behalf of community addictions services in WCJSs. This meant that some women could be on a methadone prescription within two weeks instead of the six weeks to two months that it would take using traditional routes.

• WCJSs with multi-disciplinary teams could work with women who presented with dual or complex diagnoses to address issues simultaneously (e.g. substance misuse and mental health). Practitioners reported this was an advantage over mainstream services (e.g. mental health, GPs), which sometimes could not support women until substance misuse was stabilised:

"A lot of [women] might have a dual diagnosis. They might have substance misuse, which means the mental health services will say, "We can't really work with you, because you need to get that addressed first." Whereas they can come here and [the nurses] will attempt to work with them on whatever issue is most pressing at that time."
- Team Manager, WCJS Women's Team

• Women could maintain consistent support from workers in WCJS despite delays or long periods between contacts with their addictions worker. Practitioners and women indicated that addictions services were very busy (cited by two WCJSs, but may have applied more widely), which impacted on the intensity and consistency of support available to women.

Purposeful activities (leisure, education and work) support

6.43 Half of all women (52%)^[42] entered WCJSs without interests or positive ways to spend their time. And more than half (61%)^[43] were not in work, volunteering or training (this was much higher among women with dual or complex needs).

6.44 There is growing evidence in the desistance literature that having purposeful activities reinforces positive identities and reciprocal social relationships that enable individuals to relinquish negative behaviours and provide 'hooks' for change.^{[xiii] ,[xiv]} Lack of interests or 'empty' time exacerbates boredom and social isolation, which have been linked to poor mental health and drug use.^[xv] As one practitioner stated, building positive social connections was important for women to 'exit well' from WCJSs, and was critical for WCJSs' shared, long-term aim for women to participate positively in their communities.

6.45 Support for women to develop purposeful activities was driven by an individual's 'readiness'. Support was provided by key workers, mentors, or in groupwork to build women's confidence or promote new experiences or interests (e.g. cooking, gardening, outings to libraries, museums, recreation centres, user-led projects, charity campaigns, community college courses, voluntary roles in WCJSs or externally). Specialist employment providers (e.g. APEX) in some WCJSs facilitated sessions or received referrals. Several WCJSs had allocated specific resources within WCJSs to build women's social capital and links in the community (see Box 8).

6.46 However, despite it being a high area of need, it was also the need least likely to be addressed overall. This was probably because many women entered WCJSs with complex circumstances and priority was given to address immediate needs and achieve stability (in the timeframes of the evaluation). Practitioners were also conscious of the need to promote achievable expectations for women.

6.47 That being said, there was a strong and consistent desire from the women interviewed for activities in their lives that they would find rewarding and purposeful; and support that would help them achieve their goals to 'move on' into work, training or volunteering when they were ready. Women who were not yet ready to move on still indicated a desire for purposeful activities and wanted more groups or practical opportunities to learn new skills in drop-in sessions (see also Annex G for summary of WCJSs' learning regarding group based support). These activities were highly valued and contributed to positive outcomes in other areas of women's lives, particularly mental health.

Box 8: WCJSs linking women to activities in the community

Several WCJSs had a specific focus towards facilitating links for women in the community through new interests, volunteering, work or education. Effective features of their approaches were:

An allocated team member with expertise and resources to work with women to help develop their interests and links into the community.

A plan that was client-led, tailored to women's circumstances and interests. Having a plan appeared to be powerful for some women:

"[…my worker has] got me a career person, someone to help me back on to the ladder to work. I get up every morning before nine o'clock but before April I wouldn't even care. I've got a purpose and an action. I've got a plan and I've got a way to move forward. I see a future that I smile about and I never felt that before April."
- Emma (late 40s), service user

Distinct groups or opportunities in the service for women wanting to 'move on', such as drop-in groups, specific groupwork programmes, peer-led support, or formalised voluntary roles, which promoted independence, confidence and a motivating environment for this group of women:

"[The group is for] women who have come out the other side and are now wanting to start building a life for themselves, whether they want to go back to college, go back and learn, access training, access education, voluntary situations … I think people underestimate maybe three or four hours on a Friday, women together and just that it really is quite powerful. We kind of do encourage each other."
- Vicki (30s), service user

Engaging women into WCJSs

6.48 Overwhelmingly, WCJSs practitioners reported that it took considerable time and resources to engage some women in WCJSs. Engagement^[44] was an iterative process, and for some women it could take several months (in voluntary cases) and/or took multiple and varied approaches.

6.49 Immediately prior to entering WCJSs, women commonly reported feeling stressed, fearful, or anxious and didn't know what to expect. The reasons why some women found it difficult to initially engage with WCJSs were consistent with existing evidence about non-engagement with mainstream services in general.^[xvi],[xvii] These included chaotic personal lives, travel time or cost (women indicated a limit on journeys of two or more bus rides), poor health, feeling stigmatised, and mistrust of professionals (e.g. social work):

"I was ashamed of myself and the shame got to the stage that I didn't want to communicate with anybody in the social work side, the police side or even the housing side because I felt these people hurt me and they took the most precious things away from me; my home and my children […] I come here and I realise they were all social workers, criminal social workers. I was so frightened, I just wanted to run out the door."
- Mary (late 50s), service user

Statutory engagement in WCJSs

6.50 In Scotland (where most WCJSs are CJSW-based) the majority of women entered WCJSs to comply with court orders (section 5). Quantitative data indicated that women who engaged on a statutory basis were less likely to disengage and may stay in WCJSs for longer relative to women who engaged voluntarily (see Table 9 below). Personal motivation is particularly important where women are expected to engage voluntarily, as this woman highlighted:

"If it was years and years ago when I was offending and somebody says, "You can go somewhere voluntary." I probably wouldn't [have] because when you're still in that chaos you're not going to go anywhere. You only go if you're forced to go. So I think it depends on the place that you're at yourself."
- Vicki (30s), service user

6.51 On the other hand, some women and practitioners recognised that orders could have the opposite effect on attendance and hindered practitioners' ability to establish and maintain relationships with women. To illustrate these two approaches in practice, Box 9 contrasts the use of statutory compliance in Angus's Glen Isla Project with the voluntary approach of TWG to engaging women in WCJSs.

6.52 The tension between enforcement and support aspects of statutory supervision, and its effect on engagement, has been highlighted in previous studies.^{[viii], [xviii]} There is no consensus on the 'right' approach, but it is clear (from studies and evaluation findings^[xvi]) that women's motivation, relationships with workers, proactive outreach, and provision of holistic support are all important factors in engaging women, whether attendance is voluntary or mandatory.

6.53 Several practitioners described managing the tension between compliance and maintaining relationships. At the outset, they requested flexibility within the order from sentencers (i.e. a preference for the statutory component to apply to supervision rather than a direct programmatic requirement^[45]), and, if breach was necessary, they aimed to make it 'meaningful' (i.e. continued to work with women through the breach process if possible to maintain the relationship and access to holistic support, see Box 9):

"If I still feel that I can get somewhere [I] put the breach in but work with that woman voluntarily […I] agree with that woman, "Let's try and sort this out. I have to put the breach in, but it's not all over." With that, you're maintaining the credibility of the Order, but you're still trying to help. I've got one particular woman and it's really worked so well. […] She said, "You gave me a second chance and I'm not going to throw it back in your face"."
- Social worker, WCJS Women's Team

Box 9: Contrasting approaches to engaging women in WCJSs

Mandatory attendance - Glen Isla Project, Angus

Practitioners in the Glen Isla Project have CJSW case responsibilities and most women attended under orders. Glen Isla introduced a 'zero tolerance' approach to non-compliance by using 'meaningful breaches' for women, including many on high tariff structured deferred sentences (HTSDS):^[46]

"If somebody is fifteen minutes late for an appointment, we will breach their order. They will be picked up that night, ninety-nine percent of the time because the police prioritise that and she will appear the next day. [… We] send a Rapid Report in that morning to court [… the Sheriff will say to women], "I'm letting you out, but this is what you are going to do." […] So, although we would regularly breach women, we would also be standing in court saying, "We want her back", which we wouldn't have been before."
- Team Manager

Critical elements of this approach included that the WCJS emphasised relationships, a holistic support and outreach alongside compliance; the police and Sheriffs were on-board (the 'zero tolerance' approach would not have been used if it risked an outcome that social workers didn't intend or expect for women, such as custody); the use of a Rapid Report to inform the Sheriff on women's progress and proposed action; and that the Sheriff spoke with women directly, which women reportedly found 'really powerful' (the effect of positive interactions with sentencers was identified by other women in the evaluation and also in previous studies).^[xix]

As a result, practitioners observed improved engagement with women who were 'previously cycling through courts'.

Voluntary attendance - Tomorrow's Women Glasgow (TWG) centre

TWG's target group was women with high or complex needs. Local CJSW teams managed any orders. Attendance was voluntary on the basis that this better enabled practitioners to maintain consistent relationships and support for women, and the consequences of non-compliance with mandatory orders was a less effective deterrent for women who led chaotic lives or had been in the justice system a long time.

Practitioners reported that although initial engagement was often extremely challenging and in some instances took months, the voluntary approach helped to establish trust and women worked with them better because breach wasn't a possibility:

"I came from criminal justice initially […] So if you didn't turn up for that appointment you were given two shots or three. […] I prefer the voluntary because I get a lot more scope and they work with me better knowing that I'm not the person that is going to breach them. […] We are not acting on behalf of the courts, the police, or the children's panel. She is at the centre and our role is to support her to do well."
- Practitioner

Effective engagement strategies

6.54 Evidence from interviews and the quantitative data suggests that practitioners were effective at maximising women's engagement in WCJSs. This was attributed to WCJSs' efforts to place relationships at the centre of their practice, and proactive outreach:

• Relationships: Practitioners (and women) stressed that 'relationships' underpinned successful engagement. For many practitioners, this meant getting women 'on board from day one by being absolutely inclusive in the decision making' and 'not giving up':

"I think if a woman thinks that we don't care, or we are not bothered if they don't turn up… It's a much harder job to get them in."
- Practitioner, WCJS Women's Team

• Proactive outreach: Practitioners across most WCJSs reported visiting women at home, meeting women outside CJSW offices, linking with women's existing support (e.g. mentors), providing transport (e.g. pick ups or bus tokens), and responding actively to non-attendance beyond just 'firing out letters'. One practitioner reported doing 'more court reports in women's homes in the last six months than the last five years'.

6.55 For some established WCJSs, 'outreach' was practiced already, but was now accepted as routine practice. For one practitioner, shifting out of CJSW premises was critical to supporting this change in culture:

"We don't think what we are doing now is going the extra mile, it's what [women] should be getting as a service and there was no way we would have been able to do that in the same way we were a year ago. […]. Even if people had really wanted to do something differently … they would have been sitting next to a social worker who thinks it's ridiculous to take somebody out for a coffee. They would then have the pressure of that as well. It just wouldn't ever have worked."
- Team Manager, WCJS Community Hubs

6.56 Practitioners reported that while proactive outreach was effective (as has been highlighted in previous studies^[xx]), it was time and resource intensive, particularly in WCJSs that were voluntary, or in rural or dispersed areas where it was not unusual for a worker to drive 50 miles or more in one day to work with women.

6.57 In offering voluntary support, two WCJSs found it effective to attach information for women about the WCJS to court reports (and made support available regardless of the sentencing outcome). Hearing what women themselves said about WCJSs was also a motivating factor for some women to engage (e.g. by word of mouth or reading quotes/stories from women in leaflets).

Exiting from WCJSs

6.58 Just over 500 women exited WCJSs between April and December 2014. The majority (66%)^[47] left because they had completed their order or programme, or no longer needed support. Overall, 14%^[48] women stopped attending (i.e. disengaged after entering the WCJS).^[49]

6.59 Table 9 shows exit information by voluntary or statutory engagement (excluding unknown nature of engagement). Disengagement was higher among women who attended voluntarily relative to those who attended on a statutory basis. Not surprisingly, disengagement from services tended to be among women with high and complex needs. Box 10 below provides further details on the population of women who disengaged from WCJSs.

Table 9: Reasons for exiting WCJSs

Women who exited WCJSs between 1 April and 31 December 2014 (514 women)*

Nature of engagement**	Statutory (274)		Voluntary (150)		Unknown (90)		Total (514)
Main reason for exit
Completed support/programme/order	190	69%	84	56%	65	72%	339	66%
Stopped attending (i.e. disengaged)	22	8%	49	33%	3	3%	74	14%
Revoked due to breach†	23	8%	0	0%	7	8%	30	6%
Revoked due to review	12	4%	3	***2%	9	10%	24	5%
Other reason	21	8%	12	8%	5	6%	38	7%
Unknown	6	2%	2	1%	1	1%	9	2%
Length of time in WCJS ††
0-6 months	152	55%	109	73%	33	37%	294	57%
7-12 months	72	26%	26	17%	28	31%	126	25%
13-18 months	28	10%	10	7%	6	7%	44	9%
Over 18 months	22	8%	3	2%	5	6%	30	6%
Unknown	0	0%	2	1%	18	20%	20	4%

Note: Total percentages may not equal 100% due to rounding
* Excludes 130 women in Kilmarnock Court Action Note project.
** Excludes 90 women for whom nature of engagement (voluntary or statutory) was unknown.
*** Some women may attend voluntarily but have a statutory order held outwith the WCJS.
^†This does not include women who were breached but continued in the service.
^†† These proportions likely underestimate the true length of time women may remain in WCJSs in the future given the limited time that some WCJSs were in operation and timescale of the evaluation. Figures exclude those for whom the nature of engagement was unknown.

6.60 Practitioners reported that while many women felt ready to leave at the end of an order, some women remain for longer. Practitioners' views varied on the length of time necessary to see meaningful changes in lifestyles, or for women to feel confident enough to engage with mainstream agencies or community resources without support.

6.61 However, typically women will not spend more than 12 months in WCJSs; only one third^[50] of women entered WCJSs on orders of more than 12 months; and of women who exited from established WCJSs, approximately one in five women (18%-22%) had remained in the WCJS for more than 12 months.^[51] Overall, women on statutory orders appeared to engage longer relative to those who attended voluntarily (Table 9). However, the target groups of some WCJSs meant it was not unexpected that some women engaged voluntarily for a short time only (e.g. WCJSs that targeted women with high need/risk; had time limited engagement (for low-risk diversion); or was specifically targeted to a need that may not warrant a long period of engagement). Given the short timeframes of evaluation, further study is needed to confirm this trend over the longer term.

6.62 Women interviewed did not indicate an appropriate period for being in WCJSs. However, the option to stay on voluntarily (e.g. to attend drop-ins or keep in touch with their key worker) beyond their order was very important for some women. This provided reassurance that support was available even if they didn't continue to attend regularly:

"I don't know where I would go now if I weren't able to come back voluntarily. I would slip back down again. Whereas being able to come back on a voluntary basis is keeping me going and keeping me being positive […] There's a lot of things that I'm hoping to move on to, like volunteering and college and stuff. And being able to come back here, and get the help from the workers, that's going to help me to move on."
- Molly (30s), service user

6.63 Some WCJSs advocated successfully for women's orders to be extended in order to provide sufficient support to prepare for exit, which women viewed positively (notably all women who mentioned this were involved in the decision to extend their order):

"The judge gave me this three months to work with the women's group. So, then I actually asked for another three months … because I like to go and meet with [my key worker and mentor] and going up for a cup of tea and somebody to speak to. The help is there."
- Chelsea (30s), service user

6.64 In practice, most WCJSs operated an informal 'open door' policy for women beyond their order in all or aspects of their service. Dundee's WCJS partnered with non-CJSW agencies to create a voluntary 'drop-in' group as an option for women wanting on-going contact.

6.65 However, practitioners in most WCJSs had concerns for the capacity of resources to provide on-going support, particularly where services were funded for statutory cases only, or as demand for the WCJS grew.

6.66 Other strategies practitioners emphasised in order to help women 'exit well' from WCJSs included having a clear post-exit plan and support. For example, women in Angus's Glen Isla Project were encouraged to continue using their 'Wellbeing Web' booklet when they exited and invited to get in touch if they fell below an agreed threshold.

Box 10: Women who disengaged from WCJSs

Table 10 profiles a subset of women who disengaged from services compared to women who successfully completed their time in WCJSs (i.e. completed their order or programme, were discharged early or no longer needed support).

Women who disengaged with services had more complex needs, were less willing to work on their problems, tended to be younger, had more previous convictions, and had high or very-high LS/CMI scores.

Not surprisingly, women who disengaged from services made less progress than those who completed their order or programme, despite both groups being in services for a similar length of time and receiving similar support.

The disengaged group (albeit only 40 women of which outcomes data was available for only half) were more likely to leave WCJSs with more criminogenic needs unmet, including unsafe or unstable housing, a lack of family support, and serious substance misuse issues.

Table 10: Profile of women who disengaged from services

Women in 13 WCJSs who entered and exited between April and December 2014*

	Women who stopped attending (40)	Women who completed their order/programme (144)
Average age	32	36
Had three or more previous convictions	63%	26%
Had high or very high LS/CMI scores	28%	7%
Attended on a voluntary basis	68%	31%
Length of time in services	3.3 months	3.6 months
Average number of presenting needs	7	5
Average number of areas of support received	4	5
Women's circumstances at exit (where exit and progress information was available)	21	120
'Got better' in at least one outcome (average)	48% (1)	88% (5)
'Got worse' in at least one outcome (average)	67% (3)	9% (0.1)
Ready to work on problems	14%	88%
Engaging with services	29%	94%
Stable and supportive family relationships	14%	73%
Safe/stable housing	38%	92%
Stabilised or no substance use	29%	82%

* Base figure is the 184 women who entered and exited between April and December 2014 and whose main reason for exit was either 'stopped attending' or 'completed support/ programme/ order. (Excludes Kilmarnock (130) and Highland (8) where progress was not recorded). These figures are lower than those reported in Table 9 as they exclude women who entered before April 2014.

Relationships with other women

6.67 In most WCJSs^[52], women had the possibility to interact with other women in the service through group activities or drop-ins.

6.68 Overall, women described the shared experiences with other women in WCJSs as a positive aspect of their support (e.g. many attributed it to improved confidence and reduced isolation)^[53] and often contrasted this to their previous experiences of attending CJSW offices for one-to-one supervision appointments only. Women spoke of peer interactions considerably more often than practitioners did, suggesting that this was an important feature of WCJSs for women that is sometimes overlooked.

6.69 Peer interactions contributed to aspects that women particularly valued in WCJSs, such as it being a positive and non-judgmental environment:

"Nobody kind of looks down [on you] because of what you are, or what they are. Everyone is open minded and allowed their own opinions. I think that is good for the group dynamics as well. The younger girls are seeing it's not always confrontational."
- Wilma (late 40s), service user

6.70 However, women frequently commented that they had felt very anxious in drop-in or group settings initially, before they gained familiarity or confidence. The few women interviewed who had not yet attended group settings were worried about 'who else might be there', with a concern to avoid other women with whom they might not 'get on with' or had negative associations. Though, in the few cases where women were familiar with other women in the WCJS, this was largely regarded neutrally or positively (e.g. as a familiar face or motivation to attend), suggesting that women's fears may reduce after initial engagement.

6.71 That said, women and practitioners did refer to isolated incidents that occurred in WCJSs, which indicated that maintaining a safe environment and managing risks of group settings warranted on-going attention. Safety was reinforced through rules and practices. Practitioners co-developed ground rules with women, enforced zero tolerance for inappropriate behaviours, were attentive to unhealthy dynamics between women, and had non-disclosure rules about offending history. Practitioners also highlighted that group settings were not (yet) appropriate for some women.

6.72 The majority of women interviewed reported that they did not meet or mix with other women outside the WCJS.

Relationships with workers

6.73 The importance of meaningful, trusting relationships between workers and women to enable positive change has been well documented.^{[xxi], [xxii]} Women's descriptions of their relationships with workers in WCJSs indicated strongly that relationships were a cornerstone of WCJS practice and contributed towards positive outcomes. The importance of relationships was consistently underscored by practitioners:

"[…] it's the relationship building and getting the trust [of women] and the meaningful relationship to go on and do other things. It just takes time […] You can't just charge in and do things."
- Mental health nurse, WCJS Women's Team

6.74 Frequently, women also felt they could approach numerous workers in the centre or team (in contrast to a single CJSW worker). The practitioner qualities that women in WCJSs most commonly valued were consistent with those already known to underpin successful interventions:

• willing to listen, empathetic and expresses genuine care
• non-judgmental, respectful
• flexible and available
• consistent and dedicated; they 'never gave up' despite set-backs
• a belief and optimism about women's potential for change
• a 'critical friend' or advocate who positively prompts/encourages women's progress, and is 'firm but fair'^[54]:

"You've always got an excuse not to do something. And the staff, you know that they care for you. But just won't let you […], they push you, and actually push you through the barriers you need to push through."
- Lisa (50s), service user

6.75 Two practitioners highlighted that the interpersonal relationships in WCJSs provided an opportunity for women to experience what a 'healthy model of what unconditional support and secure relationships look like' (this is also recognised in the literature^[xxiii]).

6.76 Practitioners consistently underlined the time and challenges involved in building trust-based relationships with women.

Environment

6.77 WCJSs were located in a variety of premises, including CJSW offices, commercial, and community buildings. WCJSs' outreach focus meant that practitioners also met with women in homes and the community (e.g. cafes, libraries). Having sufficient space to co-locate multi-disciplinary staff from partner agencies was critical for centres and women's teams to deliver holistic support, though space was at a premium in many WCJSs.

6.78 Overall, there was strong qualitative evidence that the positive environments created in WCJSs contributed to women's improved engagement and positive interpersonal relationships (with workers and between women). This is consistent with evidence that indicates the environment is an important feature of effective services.^[xxiv]

6.79 Elements of WCJSs' environment (across all models) that practitioners and women valued most were that the service was a welcoming, safe and women-only space.

Welcoming and safe space

6.80 To the extent that premises allowed, practitioners created non-threatening, informal environments for women, aligned to trauma-informed practice (e.g. home-like furnishings, positive images on walls, private and shared spaces):

"It's still formal but not as formal as the social work department. There is other folk hearing you there as well; it's more private here. It makes a huge difference, because I like coming here. […] You can sit and speak about things you don't necessarily get to speak about. Have a coffee and a chat. The conversation would be different if it was had at a desk."
-Kirsty (late 20s), service user

6.81 Other features that contributed to WCJSs being a welcoming and safe space (in addition to positive interpersonal relationships) included having discrete branding and signage so women could remain anonymous about what they were attending, familiar and friendly reception staff, a waiting area in which women did not feel intimidated (e.g. by other CJSW clients), and controls on who 'could just walk in'.

6.82 WCJSs located outside social work offices was an advantage, because it provided a more neutral environment (e.g. for women who described negative experiences of social work) and flexibility to create a relaxed, shared environment. The role that a positive environment can have upon women's engagement and relationships with workers (and other women) was widely expressed among women:

"I get on better with [CJSW workers] now […] before it was more impersonal because you were just going to the office and seeing them. I think they get to see how you are as a person coming here [...And] you feel like you get to see them as a person as well, so it is quite good."
- Erin (late 20s), service user

6.83 Overall, most WCJSs had some on-going challenges to service delivery that related to physical premises (e.g. inflexible or limited spaces, or shared spaces such as entrance areas outwith their control).

Women-only space

6.84 All WCJSs delivered support in premises or at times designated for women only. This was easier to achieve in non-CJSW premises. Overwhelmingly, women in WCJSs were positive about WCJSs being for women only. For some, their preference was a personal one. Others felt it was important for other women, but not them specifically.

6.85 The common reasons women supported a women-only space was that it removed any mixed signals and women felt comfortable and safe to be themselves and 'open up' to others more.

6.86 For practitioners, women-only spaces were strongly supported in line with trauma-informed practice.

6.87 Whilst the majority of staff working in WCJSs were female, there was general support (or, no objection to) male practitioners in WCJSs from both women and practitioners. Several WCJSs had male practitioners in mental health, throughcare, housing or welfare rights roles. Practitioners most often cited the value of having positive male role models in WCJSs. Notably, no women identified this as a reason, but rather emphasised the relational qualities of practitioners over gender. In addition, a few staff highlighted the risk that WCJSs could become isolating for practitioners 'if we just say female offenders deal with female workers'.

6.88 A few practitioners and women however did recognise potential limits to male-female interactions in some cases (particularly for women dealing with complex trauma and abuse):

"I've had to send the order [of a female client] back to court under breach proceedings […] If the relationship was female to female I suspect that the outcomes might be better [...] female service users may well find it more inviting, if you like [and] engage with a bit more confidence and possibly disclose more information […] I'm not saying that gender is a barrier what I'm saying is that an approach from a team that is dedicated to females I think has a better chance of working."
- Male practitioner, working in CJSW

Participation of women

6.89 In most WCJSs, women were included in elements of decision-making and/or roles that helped to deliver and shape services (beyond decisions that women make in their own case management). Women and practitioners regarded their efforts to involve women positively, and that it had contributed towards better engagement and outcomes for women, such as improved confidence. This aligns to growing evidence of the benefits of co-production for services (in design and delivery) and individuals (for personal development and towards desistance).^[xxv]

6.90 The degree and regularity of women's involvement varied across WCJSs, ranging from women simply deciding on activities, group rules and providing feedback (most WCJSs), through to TWG's service-wide 'co-production', approach facilitated by external agency Outside the Box (see their learning online^[55]).

6.91 Several WCJSs had opportunities for women to volunteer in the service aimed at building confidence or enabling women to 'practice a new identity'. Most examples given were informal (e.g. peer support, welcoming new women) but a few highlighted examples whereby women received formal volunteer training, co-facilitated groups, presented with staff at public events about the WCJS, or participated in user-led groups (e.g. Justus in the Willow Centre^[56]). One practitioner in an established service highlighted their approach:

"Usually by nine to twelve months we ask [women] to take on responsibilities, roles and contribution to the service […] For example, women help with open days or grant applications for funding arts projects. […] We have demand for a new group in mentalisation, but only one staff [member] to run that, [so] two women are taking on co-facilitation who say this has changed their life and they want to teach it to others."
- Manager, WCJS Centre

6.92 Practitioners did find elements of participatory practice challenging (e.g. to balance women's ideas with ensuring realistic plans, and gathering regular feedback from women in meaningful ways), and indicated that it was part of a wider cultural change in how services might work differently with individuals.

6.93 Findings suggested that innovative practices to involve women requires a flexible operational environment. For example, practitioners in two WCJSs were frustrated that opportunities for women's participation were lost due to their local authority's rigid procurement processes (e.g. prescriptive procedures and long timeframes to purchase items limited women's involvement).