Understanding and preventing male youth violence in Scotland

Chief Scientist Office Final report form

Form 4

CSO reference number: 08-09/10

Please complete this form in Verdana 10 point font size Project title: Understanding and preventing male youth violence in Scotland: An exploration of the feasibility of data linkage and a parenting programme in Young Offenders Institution Polmont.

Start date: February 2010

Finish date: January 2011

Investigators: Professor Peter Donnelly

Professor Alastair Leyland

Dr Damien J. Williams

Ms Eric Nicholls

Professor Paul Boyle

Dr Frank Popham Summary

Violence is an important Public Health problem and a contributing factor in sustaining health inequalities in Scotland. This proof of concept study explored thepossibility ofestablishing a future long-term, cohort study involving a group of violent young males in Scotland which would seek to understand antecedents to violence, reduce violent recidivism, and tacklehealth inequalities. In addition, the current studyalso explores the feasibility of a parenting programme in Young Offenders Institution Polmont that could aid violence prevention efforts since evidence shows that improving the early year’s environment and addressing parenting among at-risk individuals may assist in breaking the cycle of violence.The broad aims were to explore the potential to collect information from, and link secondary sources of information (i.e. personal records) for incarcerated violent young men in Scotland’s sole male Young Offenders Institution, and explore the development of a parenting programme for this population. While there were some enforced changes to the proposed methods, the study was successful in identifying barriers and opportunities in relation to any future cohort study. Data available through the Scottish Prison Service (SPS) and Community Initiative to Reduce Violence mean that it is possible to access and potentially link an individual’s records inside and outside prison thereby facilitating the follow-up of a prison and community sample of violent, at-risk young men. Moreover, opportunities of working with various agencies that operate in YOI Polmont mean that primary data (objective and subjective) can be collected both during custody and upon release. Finally, discussions with SPS and YOI Polmont highlighted an interest in a parenting programme for the young men. Further, an institution–wide, selfcompleted survey and follow-up interviews with a sample of incarcerated young men allowed us to assess what would and would not be acceptable to them, and also to explore some of the issues that related to their own incarceration. We believe this will assist us in developing a programme that best suits the needs of incarcerated violent young men and therefore has the greatest potential for success.

1

Background Violence is an important Public Health problem and a contributing factor in sustaining health inequalities in Scotland. The World Health Organization World Report on Violence and Health (Krug et al., 2002) argues that more can be achieved by regarding violence as a problem of Public Health rather than one of crime. Indeed, it is recommended that a science-based, socially inclusive, public health approach to violence is required to better understand antecedents, and identify appropriate interventions in an attempt to tackle violence and the associated health inequalities. The first step in this process is to gather as much knowledge about the particular problem as possible, including risk and protective factors, characteristics of the problem and demographics of those at risk.

It has been noted that the group most affected by violence is (male) youth (defined by Krug et al., 2002, p.25 as: “people between the ages of 10 and 29 years”) both as victim and perpetrator. Indeed, adolescence and young adulthood is a time during which many types of behaviour are often given heightened expression, not least, violence (Dahlberg & Potter, 2001). Furthermore, youth violence is considered one of the first physical manifestations of health inequalities (Williams & Donnelly, 2009).

Krug et al. (2002) summarise the outcomes of international empirical research to identify the main risk factors for youth violence. One of these categories, “family relationships”, is gaining considerable prominence in the violence reduction literature (WHO, 2009) as a number of studies indicate that familial/parental behaviour toward a child is associated with greater levels of violence/aggression in later lifeand increased risk of poor parenting, which can in turn influence and be passed on to their offspring (WHO, 2007) referred to as the cycle of violence (Widom, 1989). This highlights the potential importance of implementing interventions that target the familial risk factor in an attempt to reduce youth violence (WHO, 2009).

Richard Tremblay’s (2006) paper “Prevention of Youth Violence: Why not Start at the Beginning?” summarises the argument for the need to implement preventative interventions before birth and during early childhood. In particular he argues that such approaches can facilitate the appropriate development of physical aggression and reduce violence more effectively than relying on costly, corrective interventions when physical aggression/violence has reached a level that is dysfunctional/problematic.

Working with individuals most at-risk of violent behaviours (i.e. young offenders) will enable a better understanding of the antecedents to youth violence and predicators of recidivism, which will enable the development of interventions to reduce violence in the current generation. What is more, the substantial body of literature that identifies an association between violent offending and exposure to adverse childhood experiences(including inadequate parenting)highlights the implications for the perpetuation of the cycle of violence, potentiallyresulting in the next generation of violent youths. Thus, a parenting intervention focused on violent young male offenders will not only offer a means to break the cycle of violence, but will be informative at a policy level as it will highlight the potential for such interventions to be rolled out across other “atrisk” groups. Not only do such steps offer the potential to prevent the next generation being exposed to an important risk factor for violence, it may also provide a means by which to address levels of violence in the current generation of violent youths. Indeed, it is accepted by the prison service that interventions that enhance and encourage effective communication and contact between parents and their children, thereby maintaining and improving family ties, are likely to have long-term consequences for recidivism (see Loucks, 2005).

The proposed study explores issues pertinent to future attempts to collect and link primary and secondary sources of data to understand antecedents of violence and factors predictive of recidivism, and the future development of a bespoke parenting programme for violent young offenders in Scotland.

2

Original Aims The overall aims of the proof of concept study were to explore the possibility of developing a long-term follow-up study with a cohort of violent young males in Scotland, and the development of a parenting programme for roll-out in Young Offenders Institution (YOI) Polmont. The six specific aims were: 1. Achieve ethical approval from the necessary committees and boards 2. Investigate access to a community sample through contacts in the Violence Reduction Unit (VRU) and the Community Initiative to Reduce Violence (CIRV) 3. Investigate access to offender and community-based records and explore possibilities for linking the records 4. Investigate the feasibility of collecting data via surveys/questionnaires (regarding gang affiliation, health behaviours and attitudes to violence, perception of role in society, personality, Adverse Childhood Experiences, ADHD traits) 5. Develop links with members of Scottish Prison Service (SPS) involved in a parenting programme and engage in discussion to assist the development of an intervention 6. Identify appropriate targets for parenting interventions in offender and community samples (those with children vs. those with responsibility/involvement with children [i.e. younger siblings] vs. all) and explore access to offender and community-based partners/children.

Methodology In order to explore each of the study aims a variety of activities were undertaken adopting both informal and formalresearch methods. In addition, the nature of the research activity undertaken to exploreAim 4 was altered in response to a request from SPS (as discussed below). The activity undertaken to address each Aim is presented in turn.

Activity 1. Achieve ethical approval from the necessary committees and boards In order to undertake the various components of the study applications were submitted to the SPS Research Access and Ethics Committee (RAEC) and the University Teaching and Research Ethics Committee (UTREC) at the University of St Andrews.

Activity 2. Investigate access to a community sample through contacts in VRU and CIRV A series of discussions were undertaken with members of the CIRV project team and VRU, to explore access to the gang-related youths with whom they have engaged, and the use of their intelligence database to enable retrospective and prospective follow-up of the youths.

Activity 3. Investigate access to offender and community-based records and explore possibilities for linking the records A series of discussions were undertaken with various organisations including the SPS, CIRV, General Register for Scotland, NHS Information Services Division Scotland, Scottish Children’s Reporter Administration, branches of the Scottish Government (Education and Looked-after Children and Justice) and Scottish Police Services Authority. The discussions concerned the ability to access the records of the target group of young men along with maternal and paternal records, and the potential to link these records.

Activity 4.Investigate the feasibility of collecting data via surveys/questionnaires (regarding gang affiliation, health behaviours and attitudes to violence, perception of role in society, personality, Adverse Childhood Experiences, ADHD traits) The anticipated method was altered in line with a request from SPS to investigate what information was collected by the various external agencies that work with the young men in YOI Polmont as this was unknown/not recorded.It was felt that agreeing to this request 3

would maintain a good working relationship with SPS, which would be critical to subsequent stages of the research project. In addition, the change was justified as the various agencies deal with many of the issues of interest to the study, and it would be unproductive to duplicate the collection of data that was already available. Moreover, experience of gathering survey data could be achieved through the parenting survey described in Activity 5 & 6.

Agencies that work with the young men were identified through administrators at YOIPolmont and contacted by telephone and email. Discussions were undertaken with the lead facilitator for each agency and observations of sessions (where possible) were undertaken to identify what information is currently collected from the young men and how and when this is collected. Additionally, requests for paperwork regarding the work of the agencies were made to further identify what work was done and what type of information was collected.

Activities5& 6.Exploring the development of a parenting intervention A series of informal discussions were undertaken with members of SPS management and YOI Polmont management to investigate the feasibility of running a parenting programme in the institution. In addition, discussions were undertaken with a counsellor and service co-ordinator at the Relationship Education and Counselling Team (REACT) who deliver parenting support to CIRV clients, and with a representative of the Positive Parenting Programme (Triple P) delivery team in Glasgow in order to explore the possibility of a runthrough parenting support service for young men upon release from YOI Polmont.

Furthermore, in order to seek to understand the opinions of the young men, ashort, 15item, self-complete survey was developed (see Appendix 1.) which aimed to explore three broader issues: the youths’ family structure(items 2-6) parenting and experiences of caring for young children(items 7-10 and 14) and experience and development of a parenting programme (items 11-12). The development of the survey was undertaken through consultation with Dr Katie Buston (MRC/CSOSocial and Public Health Sciences Unit) and staff at YOI Polmont and included mainly closed questions with opportunities to elaborate on responses.

Following guidance from YOI Polmont management, the procedure for distribution and collection of the survey was similar to that used for the Offender Annual Survey: Selfcompletion surveys (and full ethics paperwork) were distributed to all young men (approx.

800) in YOI Polmont before final lock-down, to be completed overnight and then collected in a sealed envelope the following morning. In order to facilitate follow-up interviews, those young men that were willing to participate were asked to give their consent on the consent form (see Appendix 3). Only those that consented to participate in the interview had their survey cross-checked for their parental status to inform the sampling procedure.

All surveys and ethics paperwork were then separated to ensure participant anonymity.

To further explore some of the issues covered in the survey, a purposive sample of 50 young men were invited to participate in short, guided interviews (approx. 15 minutes as recommended by SPS). Participants were invited only once by prison staff to ensure there was no issue of coercion to participate. The sample included 25 individuals who had identified themselves as having a child or a child on the way, and 25 who were not parents or expectant parents based on responses to the survey. The interviews were conducted by DJW and JM, in a private office with the door closed,on the young man’s wing (as dictated by SPS). The interview guide was developed in conjunction with Dr Buston and focused on eight issues related to the themes addressed in the survey (See Appendix 2). All participants' were asked if the interviews could be recorded, were provided with a verbal explanation of the study, reminded that they could stop the interview at any time, and given the opportunity to read the interview guide prior to beginning the interview. Verbal consent was then requested and participants were invited to discuss the issues raised by the interviewer and to raise any other additional issues that they wanted to.

4

Analysis Research activities comprised informal and formal methods to explore the various aims of the study. The informal discussions with staff and relevant agencies did not involve a formal analytical process, with a description of the outcome being provided. Both of the formal activities (i.e. survey and interviews) were highly structured and, consistent with the exploratory nature of the project,analysisinvolved highlighting representative issues.

For instance, the results of the survey were presented as frequencies of responses and organised according to the three broad issues of interest: 1. Family structure 2. Parenting and experiences of caring for young children 3. Parenting programme The interviews were transcribed by the researchers and all coding and analysis was undertaken by DJW according to the five themes from which the eight questions were originally developed, including: 1. Relationship with parents/guardians (Question 1) 2. Impact of childhood experiences on offending (Question 2) 3. Characteristics of a good parent (Question’s 2, 7, & 8) 4. Ideas for a parenting programme in Polmont (Question 4) 5. Interest in attending a parenting programme (Questions 5 & 6) Results The results for each of the research activities are presented in turn.

Activity 1.

Access to YOI Polmont was granted by SPS REAC. Ethical approval for the study was granted by the School of Medicine Ethics Committee on behalf of UTREC at the University of St Andrews (Approval number:MD6629). The information sheet and consent form are provided in Appendices 3 and 4.

Activity 2.

Glasgow’s CIRVis a multi-disciplinary, community-centred initiative which brings together health, education, social work, community safety, housing, and the local community into a committed and on-going partnership to encourage attitudinal and behavioural change by violent gang-related youths. Intelligence gathered by Strathclyde Police has identified over 600 gang members in the east and 400 in the north of the city, which constitutes CIRV’s target group. To date CIRV have engaged with approx. 400 gang members, who are offered a variety of suitable services and programmes (e.g. employability programme, personal development courses, diversionary activities [east end football league]).

As a result of pre-existing relationships with CIRV and VRU and discussions with the lead analyst, it is possible to gain access to the data held on the CIRV database, in anonymised form, for the purposes of data linkage as part of the proposed cohort study. The database was described as including all information gathered as part of a focused Police intelligence gathering exercise, combined with information from other partners about each of the identified gang members, including: name(s), address, date of birth, school attended, offending history, gang activity, whether they are subject to a supervision order or involved in other youth programmes.

Activity 3.

The prison service systematically collects and holds the basic information (names, gender, date of birth, address etc.) needed for data linkage. The NHS has now taken over provision of general practitioner services to the prison service (from 2011) and this may provide useful additional NHS identifiers. Thus, given the appropriate permissions from the relevant data controllers, ethics and privacy committees there is extensive potential to use data linkage to conduct high quality research on the young people in juvenile prison.

Data linkage is not new to the prison service, for example there is regular in-house 5

assessment of drug related deaths (using data from the police) amongst (former) prisoners, and the prison service are also linked into NHS Information Services Division’s (ISD) new monitoring of drug related deaths in Scotland. It was reported that high levels of consent (on entrance to prison) are presently gained for this research and thus there is a potential consent route for further linkages. However, it must be emphasised that because a lack of consent is often viewed as a particular issue, legal (under the Data Protection Act) and ethical data linkage is only typically approved (by the relevant committees) and conducted without consent when the final research dataset is anonymised and appropriate safeguards are put in place (for example, only sharing minimal information in the linkage process).

Most obviously, the prison records can be linked to ISD morbidity data both prior to (often going back at least to the 1980s and so covering the whole life of the current young offenders) and following incarceration. Also either through ISD or General Register Office for Scotland (GROS), death records can be linked in. It may also be possible to link parental health and death records. This has occurred in the past although there is no guarantee that it would be allowed in the future. Mother’s linkage is easier and is done through ISD’s birth records to identify the mother and then link to her health and death record. Father’s is more complex (through GROS birth record) and would be limited to a sub-sample of those where the father is named and would be limited to mortality (father’s date of birth cannot be shared with ISD).

It is probable that background information on whether young people in prison have been under local authority care could be linked, as the Scottish Government has recently started to systematically collect individual level data on looked after children from local authorities. They have invested a great deal of time in assuring data is collected in a uniform way using similar definitions across the 32 local authorities (all of which have varying data collection and computer systems). This consolidation at a national level is important as otherwise linking with data from32 local authorities would be challenging.

Additionally, the Scottish Government holds data on education qualifications and this could potentially be linked (the data has been linked to the Scottish Longitudinal Study). For these Scottish Government datasets names are not held but linkage is possible through either probabilistic linkage or linking back to names in the data source. Those young people who have come to the attention of the Children’s Reporter could also be linked, although the amount of information available for linking may be reduced once the young person becomes an adult. Finally, the prison service hold offence data and this could potentially be linked to further criminal histories; as data sharing arrangements are reported to be in place with Scottish Police Services Authority and reconviction data is compiled for individuals sentenced to prison by the Scottish Government.

Activity 4.

A total of 14 agencies were identified as working with the young men in a number of areas at various stages of their sentences and upon release (see Table 1).

From the discussions and an examination of documentation provided by the agencies, it was evident that a wide range of issues are addressed, including: a. b. c. d. e. f. g. h. i. j. k. l.

Self-esteem Literacy levels Childhood experiences/trauma Sensation seeking/impulsivity Psychological distress Emotional stability Coping strategies Addiction Fear and anxiety Relaxation techniques Bullying Violent crime 6

m. Domestic violence n. Gangs and gang Culture o. Peer pressure However, these issues were largely measured and addressed through non-validated methods and techniques. In most cases, the agency had developed their own questionnaire or activities to identify the individuals’ experiences, attitudes and perceptions.

Table 1 List of agencies working in YOI Polmont Agency Polmont Young Offenders Health Centre

Area of work Health

Move On

Education

Access to Industry

Employment and Education

The Rock Trust

Personal, social, and practical skills

Visible Fictions

Education and Participation

Caledonia Youth

Sex and relationship education, counselling and clinics

Safeguarding Communities Reducing Offending (SACRO

Community Mediation, Youth Justice and Criminal Justice services

Roots out of prison

Life coaching

Renfrewshire Council

Housing

Scottish Legal Aid Board

Civil Legal Assistance

Scottish Borders Council

Social work

Young Enterprise Scotland

Education

Motherwell College

Vocational and educational training

Families Outside

Family support

Activities5 & 6.

Discussions with SPS management and YOI Polmont management identified an interest in a parenting programme. YOI Polmont had previously run a highly-commended parenting programme but was no longer operational as they did not have the staff to commit to the programme long-term. Also, the previous course was not accredited and therefore did not offer the incentive for completion by the young men that other accredited programmes did. Moreover, it was highlighted that some aspects of parenting were covered by Caledonia Youth (see Table 1) but it was felt this did not address the full gamut of issues required of a parent. Furthermore, as confirmed in the young men's’ responses in the survey, staff at YOI Polmont were not always aware of who was a father or not, as it is believed that disclosure of such information is seen by some as making them vulnerable within the institution.

Two further agencies/initiatives were identified through discussions with SPS and CIRV that were working on parenting issues with youths and/or in prison settings, REACT and Triple P in Glasgow.

7

REACT offer a youth service as part of Scottish Marriage Care which addresses anger management and relationship problems (including parenting) and have been involved with CIRV in addressing the various needs of clients.While it was reported that the agency hasnot worked inYOI Polmont,the respondents felt that a parenting programme within the institution would be a useful adjunct to the work REACT often do in supporting those released from YOI Polmont.

The city-wide delivery of the Triple P programme in Glasgow aims to promote the development, growth, health and social competencies of children and young people by enhancing parenting skills. The programme offers a range of services designed to deal with the needs of individual parents, including: mass media campaigns, parenting seminars, behavioural counselling for parents with specific concerns, group parenting skills courses for children with more severe behavioural problems, and individually tailored programmes for families who need further assistance or at risk of child maltreatment.

During the discussion with the Triple P delivery team members, a new programme ‘Transitions to Parenthood’ - was identified which is being trialled in Glasgow and comprises 4 sessions delivered to parents before their child is born. Moreover, it was noted that Triple P practitioners had delivered two sets of the group parenting skills courses in Barlinnie Prison, which were positively received.

The results of the survey and interviews with the young men in YOI Polmont are presented separately and provide the perspective of the (potential) user group.

Survey The survey was completed by 164 youths (age range 16-21) giving a response rate of 20.5%. The results of the survey are presented according to the three themes from which the original questions were drawn.

Family structure Over a third of young men (66) were brought up by both parents, however, a matching number were raised by their mother only. The remaining individuals reported being brought up by their father, grandparent(s), “other” or some combination of these. Most of the young men reported having a good (97) or OK (45) relationship with their parents,with some respondents noting “Because I've always got on with them, and I've always been able to talk to them, and they always taught me right from wrong”, “Because she did her best to give me everything I needed and helped me when I had problems”.

Fourteen young men reported a bad relationship with their parents citing a number of tragic experiences, including: “Parents were drug users”, and “I was sexually abused as a kid”. A small number of young men were not sure what their relationship was like “Because it was ok until I was 12 and I started taking drugs and drinking and I got put in care at 14”.

Over a third (67) of the young men reported that their mother and/or father had been in prison, with about a third (56) reporting having spent some time in care during their life.

Finally, most of the young men had brothers and sisters (149). Notably, there were a number of individuals who reported having 3 or more siblings (71) which included numerous half-brothers and sisters with a wide age range within each family.

Parenting and experiences of caring for young children Almost half of the young men (76) reported ever having got a woman pregnant with 36 being unsure. While the majority of the young men reported not having any children (84), about a third reported having a child (40) or awaiting the birth of a child (12) with 24 reporting that they were unsure whether they had any children. The ages of some of the children suggest that the young men had become fathers before the age of 16. It was also evident that some of the young men had had children with multiple partners, and some reported having step-children (in addition to their own). Moreover, 18 respondents reported having parental responsibility over younger siblings or family members.

8

Finally, of those young men that reported having a child18 indicated that they did not see their child while they were in YOI Polmont. Reasons for this included not wanting their children to see them in prison (2)they had no contact when not incarcerated (3) and that they were no longer in a relationship with the mother who refused to bring the children into the prison.

Parenting programmes The majority of the young men reported that they had not attended any sort of parenting programme. However, while a large proportion of young men did not respond (to question 11 of the survey; see Appendix 1) almost equal numbers indicated that they would (34) and would not (41) attend. Some of the issues noted by the young men that they would like to be covered in a parenting course included; access rights, practical skills (e.g. changing a nappy, bathing or clothing a baby), what to do when they are unwell, and disciplining a child.

Interviews Each of the five themes isdiscussed in turn.

Relationship with parents/guardians There was a mixture of responses from interviewees regarding their relationship with their parents/guardians. Some young men reported having been raised in supportive environments (“I've had quite a gidtime growing up compared to a lot of the people in here if you know what I mean, I've never had any bother or nothing”) while others experienced set-backs (“well I had a good relationship with my maw until she passed away and then I didny know my father but my grandmother I had a really good relationship with her aye sometimes we argued but”). At the other extreme, there were instances of chaotic family lives, characterised by violence (“cause my da use to batter ma mother and he broke her back when I wis a wee boy, then she got a new boyfriend, married him then he use to batter me, ma wee sister and ma wee brother”), and alcohol abuse (“Well it was bad so it was because my mam was an alcoholic…. She was just drinking all the time”).

Impact of childhood experiences on offending Despite reporting have experienced adverse events during childhood, many of the young men did not offer these as reason for being in YOI Polmont:“it was obviously all ma ain fault init”, “I was just oot getting drunk in that too much an aw that…. I made my own choices”, “‘cause I never listened to what ever ma mam ever said to us”, “drink, who I hang aboot wi an aw”. Indeed, the dominant reason offered for their offending was the influence of alcohol (“maybe just the alcohol because it’s always been around me”); however, the link with exposure to alcohol in the family home was never made.

Some young men, however, suggested that their childhood experiences were the root cause of their problems (“my mum and dad splitting up and everything…. 7 or something like that, and that’s when things started going wrong”, “I was a gid boy before he [abusive step-father] came in…. the only thing they ever done was fuckin batter us and that just made us worse”).

Characteristics of a good parent The young men identified a variety of characteristics of a good parent, which reflected what they did/did not experience: “Puts their kids before them” “One that puts boundaries in place” “Somebody that is there for you, sticks around, looks after you” When reflecting on the type of parent they are, those with young children acknowledged that the fact they were in prison made them a bad parent (“Not too good cause I'm sitting 9

in here, know what I mean”). Moreover, all interviewees responded that they wanted to be the best father they could. The prevailing issue among the parental intervieweeswas “to get out of here and stay out”. What is more, all participants reported the need to change their behaviour (“I've just got to stop being daft and grow up a bit”) which typically included stopping drinking and taking drugs, and messing around with their mates.

There was a general consensus among the young men that they did not want their children to experience what they went through (“I obviously want the complete opposite of that so if I dae I'm gonna make sure I have the opposite son if I have a wain I don’t want him ending up in here know what I mean”). Furthermore, the issue of discipline was often raised as a means to ensure their children do not follow the same path that they have (“a good parent, loving, caring make sure they are disciplined make sure my wain likes me”). More specifically, the young men often mentioned how strict they would be: “quite a laid back one [parent]” “aye, strict on some things but most things I’d just be a pushover” “a wee bit strict sometimes well about drinking and takin’ drugs” “their behaviour and their schooling and aw that…. And their attitude” Ideas for a parenting programme in Polmont The change of task allowed for an idea-generation activity around what might be included in a bespoke parenting programme for young men in YOI Polmont. Almost all youths made suggestions for the inclusion of “basic” skills, which included various combinations of the following issues: 1. Changing nappies 2. Lifting and holding babies 3. Feeding 4. Bathing 5. Clothing A number of additional issues were identified and discussed having been prompted by the interviewer, which were termed “advanced skills” including: 1. Responsibilities of being a parent 2. The need for a job to support the child 3. How to discipline a child 4. What games to play with them (for educational purposes) 5. Nutrition 6. What to do when the child is unwell 7. How to communicate with the child and mother 8. Type of environment (safety) 9. Coping with them (when they are crying) 10. Their own mental health (so that depression does not prevent them from parenting effectively) The youths’ response to the interviewer prompts differed. In some instances, the interviewer raised a particular issue and was given very simple (yes/no) responses. There were occasions when the prompt either began a brief discussion of the issue, or seemingly encouraged wider thinking by the youth who then identified other “advanced skills”.

However, for two of the youths who had children the main area of support they requested from a parenting programme regarded how to access their children when the mother denied access or had moved away making access difficult.

Interest in attending a parenting programme In general, the young men who were parents showed interest in attending a parenting programme while in YOI Polmont. In addition, there was some interest among a small 10

proportion of non-parents (“Just so I have got more experience for when I have got a child”). It was also mentioned as a means of escaping the mundane routine of prison life (“Aye, gets me oot ma cell”). Despite the possibility of such a programme offering the opportunity to break up the day, the often cited reason for not wanting to participate was that they were not yet a parent.

There was, however, very little interest in attending a parenting programme when they were released from YOI Polmont. A variety of reasons were offered for this which included rather spending time with their child than doing a course; getting support from their family (“from my ma n that they help us oot… my sister n that n aw she’s got two wains she helps us oot n that nawe”); and having other priorities (“maybe if I had the time, but I'm gonna try and get a job when I get out”).

Reflexion Following the series of interviews, it was evident that the responses of the young men differed according to the gender of the interviewer. While DJW (male) was often involved in some detailed discussion around the various interview questions (although some young men were not talkative) JM (female) appeared to get less detailed responses. As JM had previously worked in YOI Polmont on the Annual Offender Survey, was recommended by the Head of Research at SPS, and received training in conducting interviews (including observing DJW) the response from the young men is less likely to be the result of different interview technique or lack of interview skill. Given the sensitivity of the interview topic and the importance of a masculine image often associated with youth offenders, it is likely that the lack of detailed response was due to the maintenance of this image in front of a female.

As with all qualitative research a consideration of the context of the research activity is vital in understanding the interpretation of participant responses. As the young men were incarcerated, and given the need for the safety and security of researchers and participants, there was little option but to undertake the interviews in the location considered most appropriate by the prison staff. Despite interviews being undertaken on the individual’s wing, they were completed in an office with the door closed with only the interviewer present, thereby ensuring confidentiality. While most participants spoke freely, one individual (interviewed by DJW) was extremely wary of others potentially watching him through the small pane of glass in the door. Moreover, it is possible that those who gave little detail in their responses were concerned that they might be overheard talking about such sensitive issues which might make them vulnerable to “attack” by others on their wing. Moreover, for the same reasons participants may not have provided accurate information, but it is not possible to assess the extent of this.

A further consideration is that given this was a one-time interview, a lack of rapport could have influenced the validity of responses (in the sense of reflecting the individuals true experience/opinions) resulting in a public account (i.e. saying what they expect the interviewer wants to hear). While this is a valid issue where an in-depth understanding of experiences is the goal, the exploratory nature of the current study did not permit followup interviews, which would have potentially uncovered more private accounts from the young men. However, despite the lack of rapport, the disclosure of very sensitive experiences and frank discussion during the interviews would suggest that we were successful in achieving valid responses from the young men.

Discussion The findings of the proof of concept study identify a variety of previously unknown barriers and opportunities for the development of a future long-term follow-up study with violent young men in Scotland, and the parameters within which to develop a parenting programme. The findings are addressed througha consideration of the six aims of the study.

11

Aim 1 Ethical approval was successfully granted by the Scottish Prison Service Research Access and Ethics Committee and UTREC at the University of St Andrews. However, this process imposed a considerable delay in accessing YOIPolmont(for which an extension was requested, and granted). Future work building on the outcomes of the current study will need to account for the potential delay that ethical approval may impose on a project timeline.

Aim 2 Building on the close working relationship with the VRU and CIRV, abetter understanding was gained of the mechanisms for contact with the young men engaged with the initiative through the CIRV database which included personal informationon each individual.

However, despite efforts to make contact with the young men, the funding situation at CIRV at the time of the current project made facilitated contact difficult.

Aim 3 Record access and linkage is possible, which is facilitated by the information held both by SPS and CIRV. However, the extent of the linkage is constrained by practical issues. For instance, access to paternal records may not be possible in this group of young men (as the outcomes of the survey and interviews have shown) since many of them have lost fathers or not known their father. Thus, if the father’s name is not on the birth certificate, there will be no means by which to access and link these records. Moreover, despite being the biological father, they may not have played any role in the up-bringing of the young man, thus, accessing records would not be a worthwhile endeavour as the purpose of doing so was to understand the role of parents as a risk or protective factor for future violence. This is also true for absent mothers. Knowledge of family structure can, however, be identified through other means (i.e. survey or social work records).While access to records and potential for data linkage focused on the prison service, many of the issues apply to the community-based sample as CIRV hold a database containing data necessary to facilitate linkage.

Aim 4 A variety of internal and external agencies were found to be working with the young men in YOI Polmont. This work covers a number of different issues, many of which would be of interest to the proposed study. However, many of the tools and techniques used to explore these issues have not been validated and would not be appropriate for use in the proposed cohort study. Nonetheless, given the relationship that will exist between the agency workers and the young men, developing further links with these agencies opens up the possibility of utilising their time with the young men to collect the necessary data using appropriately validated tools, which would also potentially inform their work.

Moreover, a major concern with a follow-up study (particularly involving the target group of young men) is the high loss-to-follow-up upon release. While the impact of this can be buffered by record linkage (objective measures), it will not be possible to follow-up individuals’ in terms of attitudes and perceptions (subjective outcomes). It became evident through the course of the discussions that many of the agencies (particularly SACRO) maintain contact with the young men upon release. Thus, there is an opportunity for the on-goingcollection of primary, subjective information through relationships with these agencies.

Aims 5 & 6 The survey and interviews were informative in terms of understanding experiences of being parented, attitudes toward parenting and ideas for what should be included in a parenting programme. One of the main findings was that current or expectant parents were most interested in participating in a parenting programme, although there were a small number of non-parents who also showed interest. Thus, not only should it be the case that such parenting programmes be open to both parents/expectant parents and non-parents who demonstrate a genuine interest. However, most of the interested young men stated that they would only attend a parenting programme while in YOIPolmont and 12

would not attend a community-based programme when they were released. Offenders’ time in prison offers the optimal window of opportunity to deliver a parenting programme to this at-risk group.

An issue that will prove difficult with these young men is the inclusion of their partners and children, as many of the young men either don’t want to or don’t have the opportunity to see them while they are in YOIPolmont(or in some cases when they are not in prison).

It would undoubtedly be most beneficial to involve partners and/or children in any parenting programme, which may be possible in a limited number of cases. However, if this is not possible, it is necessary to develop alternative approaches to deliver a parenting programme that fits within the parameters available with this group of young men. Thus, a strategy for the provision of a parenting programme within YOIPolmont would need to adopt a multi-level approach that accommodates the varying degree of accessibility to partners and/or children.

Conclusions In accordance with the exploratory nature of the proof of concept study, a number of issues were identified that pose barriers and offer opportunities to the future development of a long-term, follow-up study with violent young men in Scotland, and the development of a parenting programme in YOI Polmont.Such a study would provide a means to understand antecedents of violence, reduce recidivism, prevent violence and tackle health inequalities. While there were some enforced changes to the proposed methods, the study was successful in achieving its stated aims.

The ability to follow-up individuals retrospectively and prospectively is dependent largely on access to routinely collected data, particularly due to the high potential of loss-tofollow-up with the population of interest. Data available through a variety of agencies and organisations mean that it is possible to access and potentially link an individual’s records inside and outside prison, thereby facilitating the follow-up of a prison and community sample of violent young men. However, opportunities to work with the various agencies that operate in YOI Polmont means that it might be possible to collect primary data (objective and subjective) during custody and upon release to complement the routinely collected data.

Further, because of the importance of parenting as a means to prevent violence by breaking the cycle of violence (and inequalities) we explored the possibility of developing a parenting programme within Scotland’s primary male young offender institution, YOI Polmont. An institution-wide self-completed survey and follow-up guided interviews with a sample of the target group of young men (parents and non-parents)enabled an appreciation of what would and would not be acceptable to them and also some of the issues that related to their own incarceration. We believe that while results from this study will assist us in moving forward with the development of aneffective intervention, further work may be required to ensure such an intervention best suits the needs and circumstances of the young men, therefore offering greatest potential of success.

Despite the slight departures from the proposed methods, the project successfully fulfilled its aims and has identified areas for further research and development.

Future research A number of avenues of future research and development are being explored based on the work undertaken in the proof of concept study.

The development of the follow-up study is being further explored along with Phil Mackie (Lead Consultant, Scottish Public Health Network) and Dr Andrew Fraser (Head of Health & Care, SPS). More specifically, a number of options will be explored with regards data 13

linkage to facilitate the development of the follow-up study. The first option is to create an anonymised cohort study of young offenders which would be updated and maintained by a dedicated staff (along the lines of the Scottish Longitudinal Study). The second option is based on the on-going process (through the Scottish Health Informatics Programme, SHIP) for increasing data linkage in Scotland which utilises a project-by-project linkage model (albeit one that will be streamlined for repeat linkage). Given that the SHIP framework offers an attractive method for simplifying, for instance, the permissions and ethicsof data linkage, it may be preferable to go down this route for the purposes of the follow-up study.

Through collaboration with Dr Katie Buston at the MRC/CSO Social and Public Health Sciences Unit, we are looking to develop a parenting programme based on the outcomes of the study, Dr Buston’s work reviewing current practice in parenting programmes in Young Offender Institution's, and the recommendations reported by Geddes, Franks, and Haw (2010). Moreover, as a result of the current study, we are also involved in thedevelopment/evaluation of parenting initiatives to reduce violence within other groups.

First, we have been contacted by Ashfield Young Offenders Institution who deliver the Lads and Dads parenting course and have requested a formal evaluation of the course.Secondly, we are involved in the development of a violence prevention parenting project (headed by Glasgow Caledonian University) to evaluate the implementation of Triple P in Glasgow among victims and perpetrators of intimate partner violence. The proposal is currently with the Scottish Government for consideration for funding. Each of these projects will enable the refinement of the parenting programme to be developed from the current proof of concept study.

Dissemination Given the exploratory nature of the study, the opportunity for dissemination (particularly in peer-reviewed publications) is limited. However, an oral presentation was given at the American Public Health Annual Conference in Denver in Nov 2010: Williams, D. J., & Donnelly, P. D. (2010). Breaking the cycle of violence: Developing an intervention to address family violence and the risk of future violence. American Public Health Association Annual Conference, Denver, 6th-10th November.

Research workers The research workers, included: Dr Damien J. Williams(DJW) was involved in the study activities that took place in YOI Polmont and in the community Dr Frank Popham was involved in the exploration of the record access and data linkage.

Dr Anna Gavine was involved in the community-based aspects of the project particularly the availabilityof parenting support in Glasgow Jennifer McLaughlin (JM) was involved in the study activities that took place in YOI Polmont TJ Frame was involved in the community- and prison-based aspects of the project.

Financial statement The financial statement was sent independently by the Research Funding Office at the University of St Andrews.

14

References Dahlberg, L. L., & Potter, L. B. (2001). Youth violence: Developmental pathways and prevention challenges. American Journal of Preventive Medicine, 20(1), 3-14.

Geddes, R., Frank, J., & Haw, S. (2010). Interventions for Promoting Early Child Development forHealth: An environmental scan with special referenceto Scotland.

Accessed 25th November 2010 from https://www.scphrp.ac.uk/node/103 Krug, E. G., Dahlberg, L. L., Mercy, J. A. Zwi, J. B., & Lozano, R. (Eds.) (2002).World report on violence and health. Geneva: WHO. Loucks, N. (2005, March). Prison without bars: The experiences of families affected byimprisonment.Families Outside Briefing Paper, 1. Accessed on 11 November 2009 from http://www.familiesoutside.org.uk/assets/show.php?id=5&p= Tremblay, R. E. (2006). Prevention of youth violence: Why not start at the beginning?

Journal of Abnormal Child Psychology, 34(4), 481-487.

Widom, C. S. (1989). Child abuse, neglect and violent criminal behaviour. Criminology, 27(2), 251-271.

WHO (2007). The cycles ofviolence: The relationship betweenchildhood maltreatment and the risk oflater becoming a victim orperpetrator of violence. Accessed 11 November 2009 from http://www.euro.who.int/__data/assets/pdf_file/0008/98783/E90619.pdf WHO (2009). Violence prevention: The evidence. Accessed 25th January 2011 from http://www.who.int/violence_injury_prevention/violence/4th_milestones_meeting/publicat ions/en/index.html Williams, D. J., & Donnelly, P. D. (2009). A public health approach to youth violence: Understanding youth violence and addressing the needs of violent youths. Poster presented that the Faculty of Public Health Scottish Annual Conference, Peebles, 12-13th November 2009.

15

APPENDIX 1 A study of the need for a parenting programme among young men at Polmont YOI Young men Questionnaire Summary of Research: The University of St Andrews in collaboration with SPS is conducting a proof of concept study to identify the need for a parenting programme for the young men in Polmont and the feasibility of such a programme. We would appreciate your time in completing the following questions to aid us in this process.

1 How old are you?

2. Have you even been in care before?

Yes □ No □ Not sure □ 3. Who brought you up?

Mum □

Dad □ Both Parents □

Grandparents □

Other □

4. What was your relationship like with your parents?

Good □

ok□

bad □ Not sure □

Why? 5. Do you have any brothers or sisters?

Yes □

No □

Not sure □

If yes how many?

6 Has your Mum or Dad ever been in prison?

Yes □

No □

Not sure □

7. Do you have any children of your own?

Yes □

No □

One on the way □

Not sure □

If yes how old are they?

8.

Have you ever got a girl pregnant?

Yes □ No □ Don’t know □

9. Do you have parental responsibility for any other younger children than your own?

No □ Yes □ Don’t know □ (if yes please tick who from list below) Brother □ Sister □ Step child □ Niece/Nephew □ Cousins □ Other □ 10. If you have children do they visit you in Polmont?

Yes □ No □ No I do not want to see them □ I do not see my child/children on the outside □

16

11. Would you attend a parenting course while in Polmont?

Yes □ No □ Maybe □ 12. What things would you like to learn more about to do with parenting?

Nothing How to spend more time with them whilst in Polmont How to get on with/or continue to be a good dad with my child in Polmont and on release Practical skills like changing a nappy, bathing or clothing a baby Other (please state)

13. If you are a father is this something other people in Polmont know?

No □ Yes I talk about it a lot □ Have mentioned it to some people □ Only one or two know □ Only staff know □ 14. Is there anything you would like to say or add about parenting?

Thank you for taking the time to complete this survey.

17

APPENDIX 2 A study of the need for a parenting programme among young men at Polmont YOI Young men interview guide 1.

2.

3.

4.

5.

6.

7.

8.

Relationship with parents/guardians growing up What makes a good parent Impact of childhood experiences or parents on criminal behaviour Ideas for a parenting programme in Polmont Interest in attending a parenting programme while in Polmont Interest in attending a parenting programme when released Reflection on type of parent they are (if a parent) Kind of parent they would like to be and how to achieve this?

18

APPENDIX 3 Consent form for prison survey and interviews

PARTICIPANT CONSENT FORM Project T itle A study of the need for a parenting programme among young men at Polmont Researchers’ Name’s

Supervisors’ Name’s

TJ Frame (tjf31@st-andrews.ac.uk) Jennifer McLaughlin

Professor Peter Donnelly (pdd21@st-andrews.ac.uk; 01334 463560) Dr Damien J. Williams (djw11@st-andrews.ac.uk; 01334 463481)

The University of St Andrews attaches high priority to the ethical conduct of research. We therefore ask you to consider the following points before signing this form. Your signature confirms that you are happy to participate in the study.

Consent The purpose of this form is to ensure that you are willing to take part in this study and to let you understand what it entails. Signing this form does not commit you to anything you do not wish to do and you are free to withdraw at any stage.

Material gathered during this research will be treated as confidential and securely stored in a filing cabinet or as a sound file on a secure computer, which may be transcribed and stored on a secure computer for 3 years. Please answer each statement concerning the collection and use of the research data.

I have read and understood the information sheet.

I have been given the opportunity to ask questions about the study.

I have had my questions answered satisfactorily.

I understand that I can withdraw from the study at any time without having to give an explanation, and that I do not have to accept the invitation to complete additional research activities.

I understand that my data will be stored for a period of 3 years before being destroyed.

Yes Yes Yes Yes

No No No No

Yes

No

I agree to participate in the questionnaire study I agree for my responses to the questionnaire to be published in anonymous form as part of this research I agree to participate in the interview I agree to being tape recorded during the interview I agree for quotes to taken from the tape recorded material to be published in anonymous form as part of this research

Yes Yes

No No

Yes Yes Yes

No No No

In addition to the completion of a questionnaire, you will be invited to participate in a short interview, which will involve recording your responses. These recordings will be kept secure and stored anonymously and may be transcribed for analysis.

19

Participation in this research is completely voluntary and your consent is required before you can participate in this research. If you decide at a later date that data should be destroyed we will honour your request in writing.

Name in Block Capitals Signature Date

20

APPENDIX 4 Information sheet for prison survey and interviews

PARTICIPANT INFORMATION SHEET Project T itle

A study of the need for a parenting programme among young men at Polmont What is the study about?

We invite you to participate in a research project about your views and experiences of parenting

The broad aim of the study is to explore your views of parenting (if you have a child/children or not) and the need and interest amongst the young men at Polmont in a parenting skills programme.

Do I have to take Part?

This information sheet has been written to help you decide if you would like to take part. It is up to you and you alone whether or not to take part. If you do decide to take part you will be free to withdraw at any time without providing a reason.

What would I be required to do?

You will first be asked to complete a short questionnaire. You will then be invited to participate in a short discussion with a researcher, which will take place at a time agreed by you and Polmont staff.

Will my participation be Anonymous and Confidential?

Only the researcher(s) and supervisor(s) will have access to the data which will be kept strictly confidential.

Your permission maybe sought in the Participant Consent form for the data you provide, which will be anonymised, to be used for future scholarly purposes.

Storage and Destruction of Data Collected The data we collect will be accessible by the researcher(s) and supervisor(s) involved in this study only, unless explicit consent for wider access is given by means of the consent form. Your data will be stored for a period of at least 3 years in an anonymised format on a computer system and in a locked storage cupboard, before being destroyed.

What will happen to the results of the research study?

21

The results will be finalised by 2010 and written up as part of a report to the Scottish Collaboration for Public Health Research and Policy as well as with submissions to academic journals and/or for presentation at conferences.

Are there any potential risks to taking part?

There are no risks involved in taking part Questions

You will have the opportunity to ask any questions in relation to this project before giving completing a Consent Form.

Consent and Approval This research proposal has been scrutinised and been granted Ethical Approval through the University ethical approval process.

This project has also been reviewed by the Scottish Prison Service Research Access and Ethics Board.

What should I do if I have concerns about this study?

A full outline of the procedures governed by the University Teaching and Research Ethical Committee is available at ://www.standrews.ac.uk/utrec/complaints/ Contact Details

Researcher: TJ Frame (tjf31@st-andrews.ac.uk) Jennifer McLaughlin Supervisor: Professor Peter Donnelly (pdd21@st-andrews.ac.uk, 01334 463560) Dr Damien J. Williams (djw11@st-andrews.ac.uk, 01334 463481)

22