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Meet the team: Peer Mentors in Custody

Also:

  • Davey Nicholl- Governor HMP Maghaberry
  • Gillian Winters- Head of Learning and Skills, Belfast Metropolitan College
  • Anne McColl- UK Director Education, British Red Cross
  • Elaine Toner- Senior Nurse Manager, SEHSCT, HMP Maghaberry
  • Barry Rooney- Health Development Worker, Prison Setting, SEHSCT

The Idea

‘Community exists for the sake of belonging and takes its identity from the gifts, generosity, and accountability of its citizens. It is not defined by its fears, its isolation, or its penchant for retribution.’                              Peter Block

Prison can be a difficult and isolating environment, both for people in custody and for those who provide care. This project recognises the possibility of community, and the restorative structure of belonging. Founded on the principles of community based health and harnessing the great potential of people in custody, it is planned to commence a health care peer mentoring programme in Maghaberry Prison.

Partnership

This is an inter-organisational venture building on a Whole Prison Approach to health and wellbeing. It is a collaboration between four stakeholders:

·      Northern Ireland Prison Service with responsibility for people in custody.

·      South Eastern Health and Social Care Trust, providers of prison healthcare.

·      Belfast Metropolitan College contracted to design and deliver education and training.

·      Red Cross experts in conducting Prison Community Based Health Programmes

 

Evidence of Impact of Prison Healthcare Peer Mentor Programmes

Incredible work has already been conducted by the Red Cross in the Irish Prisons, where a community based health programme has demonstrated a highly positive impact to participant’s wellbeing. It has led to health promotion initiatives such as improved cell hygiene, oral health, HIV testing and weapons amnesty. Making a real difference to life in prison (Irish Red Cross 2017).

To develop the health care peer mentor programme we are planning to partner with the Red Cross to help with community based training in HMP Maghaberry. The Red Cross will bring their expertise and the empowering values of their organisation to this initiative.

The Approach- Peer Mentor Programme and Support Hub

Cultural transformation is taking place in the Northern Ireland Prisons with a move towards person centred care.  There are already peer mentors working in the prison trained by in-reach community organisations, providing advice for issues such as housing, literacy and employment. Currently there are no health care mentors in HMP Maghaberry. This collaboration is working towards a standardisation of the training and support for peer mentors. A Support Hub in the Learning and Skills department of the prison will be established to provide network meetings, supervision, education and training opportunities.

The new programme will ensure that peer mentors will receive recognition and reward for the vital work they conduct and will gain accreditation. These skills and qualifications will be transferable into the community on release from prison, and will promote integration and rehabilitation.  

QI Proposal -Healthcare Peer Mentors

This proposed initiative is part of an ongoing quality improvement (QI) project in HMP Maghaberry, focusing on providing a welcome to people as they enter prison. The project recognises communication in the first days of custody being crucial to safety, belonging and rehabilitation (Figure 1).

The work will involve co-designing the key messages communicated as people enter prison. Peer Mentors are central to this work in the design process and in the navigation and signposting of people to services. They will help to demystify the prison and healthcare structures.

Health Care Peer Mentors will link with everyone in the first 24 hours in prison, starting with ‘hello’ on the first morning of custody.

Peer Mentors will be involved in co-delivering induction about health care services in the first week of prison, shaping people’s expectations of prison health care. Much evidence is available of the power of peer-to peer conversations (Bagnall et al 2015, Q Lab 2018).

Project Benefits

The QI Project will enable an improvement in trust, communication and relationships amongst people in custody and the staff. The training programme, will facilitate a community of peer mentors to lead in public health campaigns, focusing on what matters to people in prison. Campaigns will improve the prison environment and experience reducing incidents and complaints. Alongside the Red Cross training and peer mentor accreditation people will be supported to become trainers and promote programme sustainability, growing a community of active citizens.

Project Outcomes

It is planned to robustly evaluate the outcomes of the Peer Mentor Support Hub and peer mentor training programme using Q Lab (2018) findings, by examining:

·      What difference has the initiative made to the peer mentors involved. 

·      Assess the wider impact on the health and wellbeing of the prison population

·      Explore environmental improvements in the prison.

·      Recognise the significance of collaboration and partnership working.

·      Evaluate the benefits to staff.

Benefits to Q

Improvement in prison health impacts population health, tackling health inequalities.

Opportunity to share peer mentor programme and learning to Q members.

Plan to Scale and Spread successful prototype to other prisons in UK and Ireland.

Project Potential

This is a fantastic opportunity to collaborate, change culture and transform the prison health service delivery, by involving those at the centre of care in a radical community of belonging.

How you can contribute

  • Advice and expertise on developing and supporting peer mentor programmes.
  • Support on devising good outcome measures for the project- exploration of metrics explored by Q lab.
  • Networking with members involved in prison health care and the justice system

Further information

QI Committal- driver diagram- Q EX (PDF, 25KB)

Comments

  1. Guest

    Jennifer Hood 2 years, 10 months ago

    Working in prisons for many years  I feel this would be a fresh idea which would encourage longer sentenced prisoners to guide and advise other prisoners and provide themselves with a sense of achievement and worth.

    1. Jennifer- there is a great resource of people with lived experience in prison, we need to look at new models of care and delivery. By placing the person in custody at the centre of the peer mentor programme, we hope for transformation in people's lives.

  2. Guest

    Barry Rooney 2 years, 10 months ago

    This project has great potential and similar projects in the other parts of the world have had massive impact. It is focused at the core of health improvement that is, the person. Changing the culture in secure environments to adopt health as the core of rehabilitation is something that can change people and improve society as a whole.

    1. Thanks Barry- Changing culture is core to sustainable and effective care delivery

  3.  
    Excellent Project that will empower and enable people in custody to take control over their health and well-being while being supported by their peer mentors.  Look forward to seeing the outcomes. 
     

    1. Thanks Anne. It is definitely an iterative process we will learn with our peer mentors how best to communicate and provide care in such a complex setting. A radical new approach to prison healthcare

      We are still working on the outcome indicators - happy to take advice from Q members!

  4. Very important piece of work and will facilitate a compassionate person-centred approach to caring for this vulnerable group of people

    1. Thanks Cathy - through Q Exhange and the Q labs our team have gained lots of new ideas and approaches for the peer mentor support hub. Compassion has to be at the heart of the work.

  5. Guest

    Elaine Toner 2 years, 10 months ago

    Peer suuport workers will open a new world us and our service users, it shall create better channels of communication as our clients become more involved and have a say in the care we provide.

    1. Thanks Elaine- I think this project is an opportunity to change the culture of how healthcare is delivered in prisons- celebrating community assets and focusing the work on what really matters.

  6. I love this idea. I was just wondering you had considered training your peers something like ASIST a programme that would support these individuals to have a safe and helpful conversation about suicide? This is such a problem for our prison population and might enhance the safety your are working towards?

    Good luck!

    1. Thanks Helen.

      As a prison healthcare team we have partnered with the NI Prison Service to build a community of practice looking at self-harm and suicide. We are using Project ECHO @NIProjectEcho, a tele-mentoring model to connect the 3 prisons with experts in the field in preventing, responding to and supporting people in custody with experience of self-harm. Some of the staff are trained in ASIST and I think it would be great to build in this training to our healthcare peer mentor programme. Often the first responder will be someone on the landing and we want to support our mentors to be part of the best care we can provide.

      As a team we would love to hear and experience you have had within your prisons in ASIST training.

  7. I like the peer-to-peer aspect of this idea. Have you thought of using simple forms of simulation training to develop and support the training of the peers mentors? This would allow them to practice the difficult interactions that they might encounter in their role as a peer mentor. Please look at my bid #SimInPsych for a bit more about simulation training. Good luck.

    1. Steve- we haven't thought of simulation training, but it is a great idea! Previous peer mentor first aid prison programmes with the Irish Red Cross have highlighted the role of the mentors as first responders. Will definitely have a look at your project. Thanks!

  8. Ruth - re outcomes for engagement. It might be worth looking into the Patient Activation Model which is a model for profiling and measuring an individuals' activation (engagement?) in their own healthcare. There is a Patient Activation Measure (PAM) -although primarily used for people with Long-term conditions. But might be comething to adapt??

    1. Great- will explore the patient activation model, we are keen to embed robust measures from the inception of the peer mentor support hub. Are you happy to field questions about the model?  Thanks!

  9. Guest

    Hi Ruth - I ask our Peer Mentors to complete a skills audit which gives me an overview of their academic ability and areas of interest. When the Mentor agrees to work in a certain area, this may always be subject to negotiation. Personally, I feel the area they are working in should benefit them on release and reflect their future aspirations. I see the hub in Learning and Skills to be a great networking area for different departments to refer Mentors for another service where this is identified and requested by the Mentor. I also see Learning and Skills as a central point for the Mentors throughout the prison, where regular meetings could be held to help promote the community feel. This is merely a meeting point and not to influence how each service is developing their own mentors or the roles that they have.

    1. Centralising the support and learning through the Hub will build a sense of community for the mentors and enhance a whole prison approach to health. I think we should work on looking 'beyond the gate' qualifications and skills in all our peer mentor programmes.

  10. Guest

    This is a highly worthwhile project that will support the prisoners in an area which some find very confusing.  In addition, the development of Peer Mentors will personally benefit the Mentors and give them a sense of purpose and achievement.  I am highly supportive of this project.

    1. Diane

      Thanks for sharing your peer mentor code of conduct, we are hoping to build an active community with our programme and a strong value base will be core to the project.

      Any tips how to recruit people and match them to the right programmes for their interests and skills?

       

  11. This is a great idea, and very timely! There is increased public interest in prison healthcare in Northern Ireland, following recent high profile reports from the Prisoner Ombudsman. This project has the potential to benefit so many people in the prison system - recipients, providers and many others.

     

    1. Thanks Noleen

      The Committal Process has been highlighted as an area for improvement in many inspection and ombudsman reports. This QI project is focusing on placing people in custody as the centre of care as they enter prison. Transforming the committal process to include peer mentors signposting and supporting people as they enter custody.

      We want to measure the outcomes of the project, do you know of good models to measure the satisfaction and the engagement of people involved?

  12. Looks good! I support this project!

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