Investing in prevention resized

Investing in prevention

Date: 06 December 2018

Julie has had an interest in offender health since conducting a health needs assessment in the Dorset cluster of prisons. Currently, one of her research interests is focussed on the health of people under the supervision of the probation service. Julie is chair of the Southampton Offender Health Research Group and she teaches aspects of public health and clinical epidemiology on both graduate and undergraduate medicine courses. Julie is chief investigator of a study which aims to determine whether a new intervention called GATEWAY can improve the health and wellbeing of young adult offenders.

Sara is a population health scientist with experience in international development. She currently leads on the evaluation of a complex domestic abuse intervention, and is evaluating the feasibility of an alcohol intervention within sexual health clinics. She has a strong interest in the role of research and policy implementation in improving the health of populations; specifically around the ‘toxic trio’ of domestic abuse, substance abuse and mental health.

"There is a concern to meet the needs of 18-24 year olds who are involved in recurrent crime in the UK. Often, young adults will be in and out of the justice system and dealing with numerous health and social problems during their childhood and adolescence.

"We know that this age group are vulnerable but we also know that they are open to change. We were keen to explore the impact that intervention could have on their future health, wellbeing and prospects.

"Alongside No Limits and Hampton Trust charities in Southampton, Hampshire Police were looking to establish the GATEWAY intervention. GATEWAY aims to improve life chances by tackling the wider determinants of offending such as employment, housing and health including mental health and substance misuse. It also trains individuals in improving empathy.

"The NIHR had put out a call for community-based projects and we were keen to get involved with GATEWAY to see if we could help to fill the evidence gap and determine whether this intervention would have a positive impact on the future health and wellbeing of those involved."

"There is a lot of evidence that points to 18-24 years olds’ mental and biological processes being more receptive and open to change. Everyone involved in GATEWAY shares the same outlook; if we can address the wider social and health determinants that impact on involvement in criminal behaviour, it may improve their lives in the long-term.

"334 participants are being recruited to the trial, half of which will be part of the 16-week GATEWAY programme in Southampton. Eligible participants will be chosen by Hampshire Police from strict criteria that reflect those involved in low-level offending, and they will be offered three key areas of support:

• GATEWAY Navigators with a health and social care background will work with the participants to assess their needs and discover the areas they need help with. They might identify additional support needs such as attending a GP, counselling or other assistance.

• LINX workshops, run by the Hampton Trust, are intended to help the participants develop resilience and empathy. Participants attend two workshops and discover their individual risk factors related to offending while they are attending.

• Restorative justice – If there has been a victim of their crime, then a facilitated meeting with the victim, where willing, may help them to draw on their newly learned skills such as empathy, sympathy and reflecting on how their actions impact others.

"After their 16 weeks on the programme is complete, we will follow up their progress over the course of two years. In conjunction with York Trials Unit, we will be gathering evidence through face-to-face interviews at various stages on their journey. A control group, who will be offered the usual care available, will ensure we can assess robustly the effectiveness of the programme."

"The GATEWAY intervention is a shining example of what can be achieved when people work together for a common goal. Improving the health and wellbeing of young adults doesn’t just impact the now, it impacts the future and pressure on all sorts of health and public resources – not just the NHS.

"Alongside Hampshire Police, No Limits and Hampton Trust, we’re also working with Southampton City Council, the Department of Criminology at the University of Southampton, Health Economists, the NIHR CLAHRC Wessex, York Trials Unit, and other third sector bodies.

"By examining the cost effectiveness of improving health and life experiences for young adults, we will be able to predict the long-term impact on services and budgets across the NHS, local councils, the justice system and charities that offer support services.

"We are all united by a passion to prevent rather than deal with the consequences of a lack of knowledge or intervention. We want to see if we can affect the life chances of people who are disadvantaged and give them a chance to lead a healthy and fulfilling life – something that is often denied to them due to their circumstances or early life experiences beyond their control.

"By establishing an intervention like GATEWAY, we are hoping to find out if initiatives like this work and are worth the investment for the long-term."

An evaluation of GATEWAY: an out-of-court community-based intervention programme is funded by the NIHR Evaluation, Trials and Studies Coordinating Centre and is sponsored by the University of Southampton. For more information, please visit:

Find out more about public health research in Wessex by viewing the latest issue of VISION magazine

  • Summary:
    GATEWAY aims to improve life chances by tackling the wider determinants of offending such as employment, housing and health including mental health and substance misuse. It also trains individuals in improving empathy.
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