Reflections on innovation,assessment, and social change: a SPARC case study

This article challenges the terms on which donor agencies evaluate development success, drawing on a particular case to make its point. It describes the resettlement of 60,000 people squatting along the railway tracks in Mumbai, a process planned and carried out by a federation of the railway dwellers themselves, with support from the NGO SPARC (the Society for the Promotion of Area Resource Centres). The article argues that this effort, which met donor criteria for a successful project, was the tip of an iceberg. Without an appreciation of the years of learning and innovation that preceded it, and the underpinning of principles and relationships built up over many years, this achievement cannot be adequately assessed or understood – and certainly not replicated. Yet in the world of formal assessment and evaluation, there tends to be a lack of interest in the deeper learning about social change that makes such success stories possible.     

HMP/YOI Holloway: a lament but also a call to arms

Abstract

London’s oldest women’s prison is to close in 2016. The unexpected speed of the UK Government’s closure plans and the lack of alternatives for London women are a cause for concern but also an opportunity. Ironically, this announcement came at a time when both the prison and its health care were evaluated as better than ever before. Staff constitute a vital source of knowledge and expertise. Good care for women who offend relies on these ingredients. Learning from the last decade should be salvaged and further developed.     

‘You May Kiss the Bride,But You May Not Open Your Mouth When You Do So’: Policies Concerning Sex,Marriage and Relationships in English Forensic Psychiatric Facilities

In 1996, the Royal College of Psychiatrists recommended that all psychiatric facilities in the UK develop policies concerning sexuality and sexual expression for persons contained in those facilities. This paper analyses the prevalence and content of such policies in English forensic psychiatric facilities. While the College recommends an individualised approach to sexual and emotional relationships, most hospitals in fact either prohibit or actively discourage such expression as a matter of policy. The paper considers the advantages and disadvantages of that approach. The paper also considers the legal issues surrounding these policies, and in particular the legal authority for governing the sexual and emotional expression of hospital residents and the relevant human rights implications.     

Patterns of violence and self-harm in women prisoners: characteristics,co-incidence and clinical significance

Self-harm and violence in women’s prisons in England are common and occurring with increasing frequency. We aimed to describe the characteristics and patterns of violent and/or self-harming behaviours in women in prison by conducting a retrospective analysis of routine data about self-harm incidents and adjudications. Incidence rates of self-harm and violence were calculated and associated factors explored using logistic regression. We found that only 6.7% of 5486 women prisoners self-harmed and 7.9% had been violent. Eighty per cent of all self-harm incidents related to 70 women. Almost 4 in 10 women prisoners who self-harmed were also violent. Multiple incarcerations and court movements are associated with incidents of self-harm and violence. Women with high-frequency self-harm (≥6) began self-harming early in their custodial period. We conclude that women prisoners who are very behaviourally disturbed can and should be identified early. They warrant clinical formulation and multi-agency responses to risk. Those with high-frequency self-harm should be cared for by external health services.