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Program Profile: West Midlands (England) High-Crime-Causing Users (HCCU)

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on February 23, 2015

Program Summary

An intensive community-based partnership between police and treatment providers in West Midlands that provided enhanced delivery and coordinated efforts and resources to high-risk offenders to reduce their offending behavior. The program is rated Promising. The program was shown to significantly reduce the average number of arrests for participants.

Program Description

Program Goals
West Midlands High-Crime-Causing Users (HCCU) was a community-based partnership that provided more direct and intensive treatment to high-risk offenders in an effort to reduce their offending behavior. The HCCU was a partnership between the police and treatment providers in Coventry, West Midlands, in England. The HCCU provided high-risk offenders with standard arrest services such as treatment referral and access to mediation and psychosocial support, but also more intensive direct client work, such as seeing clients more often, and a more intensive partnership for each client’s case. Offenders in the HCCU scheme would move through the stages of treatment rapidly, including access to detoxification and rehabilitation treatment if needed, and would have more coordinated police responses if they were rearrested or failed to comply with their treatment plan.

Target Population
Offenders were eligible to participate in the HCCU scheme if they had been arrested at least three times in the past 12 months, had tested positive on arrest for heroin and/or cocaine at least three times in the past 12 months, and were not currently engaged in the Prolific and other Priority Offenders scheme, awaiting prison, or currently in prison.

Program Components
The West Midlands HCCU was based on the same principles as the Drug Interventions Programme (DIP), which was overseen by the Home Office in England. Both the HCCU and DIP programs were based on the belief that drug treatment can decrease crime. The DIP required offenders to be tested for Class A drugs (opiates/crack/cocaine) when first arrested. If the offender tested positive, he or she was mandated to attend drug treatment. Offenders involved in the HCCU pilot scheme received services provided to those in the DIP, as well as additional key elements such as:
  • More intensive therapeutic work, including weekly appointments with a drug worker and the opportunity to drop in as needed.
  • Greater access to a wide range of therapeutic options such as wraparound services, which would include access to housing, training, and education support, as well as accelerated access to intensive interventions such as residential rehabilitation.
  • A team that was more rapid and responsive because the drug worker and police officer were on the same team, which allowed for greater communication and faster response in the event of nonattendance or dropout.
  • More intensive police involvement and awareness of a client’s therapeutic engagement and progress, as well as more intensive police scrutiny in the event of treatment noncompliance (Best et al. 2010).
Key Personnel
The HCCU team consisted of a police officer, an experienced drug worker, hands-on management input from both the police and the treatment service management, and administrative support. Delivery of the HCCU took place in the offices of the treatment provider.

Evaluation Outcomes

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Study 1
Overall, Best and colleagues (2010) found that the West Midlands High-Crime-Causing Users (HCCU) scheme reduced arrests for participants in the treatment group. The HCCU had a statistically significant impact on arrests, as the average number for the treatment group declined by roughly 3.5 arrests from pretest to posttest. In contrast, the comparison group exhibited a slight increase in the average number of arrests (0.16).
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Evaluation Methodology

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Study 1
Best and colleagues (2010) used a quasi-experimental design to evaluate the impact of the West Midlands High-Crime-Causing Users (HCCU) scheme on crime. Fifty-six offenders were assigned to the HCCU group and 60 to the standard Drug Interventions Program referral process to treatment. Offenders were drawn from police records that identified all offenders in the community who met the eligibility criteria. Offenders were eligible if they had been arrested at least three times in the last 12 months, had tested positive on arrest for heroin and/or cocaine at least three times in the past 12 months, and were not currently engaged in the Prolific and other Priority Offenders scheme, awaiting prison, or currently in prison.

Ninety-one offenders in the sample were male, and 23 were female (data were not available for 2 of the offenders). The vast majority of the sample (89.7 percent) was white British, and 78.4 percent were single. The mean age of the sample was 30.5, with a range of 20 to 45 years old. Heroin and crack cocaine were the predominant substances used, with two thirds of the sample indicating they used heroin every day and almost half indicating they used crack cocaine every day. Eighty-seven percent indicated that heroin was their primary drug, and 12 percent reported that their primary drug was crack cocaine.

Arrest data were gathered 12 months before the intervention and 12 months following the intervention. Case and treatment records were also provided for participants in both the treatment and comparison groups. There were three sources of data gathered: arrest data, clinical case note file analysis, and self-reported questionnaire responses. A pro forma was developed by a single researcher based on an initial review of the three case files for those in the treatment and comparison group. The pro forma assessed the following areas: demographics, drug use and treatment history, baseline measures of need and criminal justice involvement, frequency of clinical contact and summary of key working sessions, delivery of therapeutic interventions, medications, session attendance and reviews, and date and reason for discharge. The evaluation used paired sample t-tests, comparing offending in the 12 months before HCCU implementation and 12 months after HCCU implementation, to determine the impact of HCCU on offending behavior.
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There is no cost information available for this program.
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Best, David, Deborah Walker, Elizabeth Aston, Charlotte Pegram, and Geraldine O’Donnell. 2010. “Assessing the Impact of a High-Intensity Partnership Between the Police and Drug Treatment Service in Addressing the Offending of Problematic Drug Users.” Policing & Society 20(3):358­­­–69.
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Additional References

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These sources were used in the development of the program profile:

Hammersley, Richard, Alasdair Forsyth, Valerie Morrison, and John B. Davies. 1989. “The Relationship Between Crime and Opioid Use.” British Journal of Addiction 84(9):1029–43.

Parker, Howard J., and Perpetua Kirby. 1996. Methadone Maintenance and Crime Reduction on Merseyside. London, England: Home Office.
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Related Practices

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Following are practices that are related to this program:

Adult Reentry Programs
This practice involves correctional programs that focus on the transition of individuals from prison into the community. Reentry programs involve treatment or services that have been initiated while the individual is in custody and a follow-up component after the individual is released. The practice is rated Promising for reducing recidivism.

Evidence Ratings for Outcomes:
Promising - One Meta-Analysis Crime & Delinquency - Multiple crime/offense types
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Program Snapshot

Age: 20 - 45

Gender: Both

Race/Ethnicity: Asian/Pacific Islander, White, Other

Geography: Urban

Setting (Delivery): Inpatient/Outpatient

Program Type: Alcohol and Drug Therapy/Treatment, Community and Problem Oriented Policing, Individual Therapy, Wraparound/Case Management, Therapeutic Communities, Alcohol and Drug Prevention

Targeted Population: Alcohol and Other Drug (AOD) Offenders, High Risk Offenders

Current Program Status: Not Active