This case-study examines a new nationally administered programme in Wales called Early Action Together that aims to establish a multi-agency approach to offending behaviour fuelled by Adverse Childhood Experiences (ACEs).
In Wales, 1 in 7 people have experienced four or more ACEs. ACEs are potentially traumatic and stressful events that occurred during someone’s childhood and can have lasting, negative effects on health, well-being and social functioning. Such experiences could range from physical and sexual abuse to the imprisonment of a parent. People who have experienced ACEs are 14 times more likely to be victims of violence, 15 times more likely to commit violence against another person and 20 times more likely to be incarcerated.
As a result, police forces in Wales tend to come into contact with victims and offenders who exhibit the symptoms of ACEs very frequently. As one police officer described, the police realised that ‘we cannot arrest our way out of this’, a better solution was needed.
Early Action Together (EAT) is a response from the police and other agencies to introduce early interventions to resolve this problem. EAT supports the police, prison and probation services to work collaboratively with multi-agencies such as schools, social services and the third sector. The aim of this programme is to identify vulnerable people who have experienced ACE, intervene early and keep them out of the criminal justice system. The programme looks to provide them with necessary services that improves their life chances.
How EAT works
EAT aims to facilitate transformation of policing in Wales to a multi-agency, ACE-informed approach that enables early intervention and root cause prevention. To do this, EAT:
- Trains front-line officers prison and probation staff so they understand the impact of ACEs and can spot vulnerable people.
- Works with police forces to make sure the way they gather information, structure their organisations and develop their staff means the forces can meet the needs of people who have experienced ACEs.
- Has created an ‘Early Help’ system that makes sure that whatever service a vulnerable person needs are provided at the right time.
- There is complete multi-agency working among all involved institutions from police, to schools, to social services.
The multi-agency part of the EAT is perhaps one of its most important. The programme is currently being delivered by a partnership of Public Health England, the four Wales police forces, police and crime commissioners, Barnardo’s, HM Prison and Probation Service Wales, Community Rehabilitation Company Wales and Youth Justice Board Wales. It is also funded through the Home Office Transformation Fund. Thus, the programme brings together all facets of care, criminal justice and social services.
The programme also provides for a comprehensive framework through which a person - usually young person - who suffers from ACEs can be helped. This is called an Enhanced Case Management.
When a young person’s case is referred. The case progresses as follows:
- Multiagency team formulation meeting: in this case, the young person’s case is examined with a focus on trauma and what could be causing it. This examination is co-facilitated by clinical psychologists. They analyse the young person’s behavioural pattern as well as where the statutory sector may have gaps in knowledge about the young person. They also examine the areas where the ACE’s may have cause the arrested development of the young person. All of this is done with a multi-agency approach
- Clinical psychology formulation report: at this stage, a psychologist provides a clinical interpretation of the young person’s current behaviour based on his/her individual history. Recommendations are then made and sequenced according to developmental needs of the young person.
- Developmentally sequenced interventions: the mantra for this stage is to provide the right intervention at the right time. As a result, it is led by the psychologist’s recommendations and tailored to the young person.
- Clinical supervision for practitioners: This is the final step, in this case the young person is regularly supervised and advised.
Evaluation
EAT has been well-received by both service users and practitioners so far. Many young people feel like they can better engage with this programme as it shows genuine care for them and their issues.
Moreover, practitioners have expressed praise for this programme with one saying that the EAT has allowed us ‘to feel less frustrated’ when confronted with people suffering from ACEs.
Another practitioner particularly praised the enhanced case management for allowing her to evidence the need of her client and acknowledge that there was not a service available to meet his needs.
Essentially, the EAT has helped practitioners get a better understanding of the problems caused by ACEs and it has helped them develop the right tools with which to solve such problems.
It has also provided a more human and responsive modem through which many vulnerable people can get help before they end up in the criminal justice system.
If you have any questions or require more information about the EAT programme, please contact the national team via earlyactiontogether@wales.nhs.uk
This case-study was compiled by Michael Farinu in 2019