A Pipe Dream?

Following on from the BBC Panorama AP programme, thanks go to the reader for contributing the following yesterday:-

The Panorama programme was carefully edited to show the worst of AP life. As others have said, they showed none of the rehabilitative work or reflective practice that is routine in a PIPE AP. Fleming House is one of the bigger hostels, so will have a Deputy Manager and a psychologist working there. However like all other APs, only 2 RWs working all night, trying to get curfews recorded, handovers updated, medication given out and the million little jobs that need doing. Yes, one of the residents didn't sign for his 7pm curfew, but he was in the AP, his whereabouts were known. (I'm not condoning him signing for him, but it could have been worse).

The AP manager didn't send off the tablets for testing. This is a new process, previously they would just have been disposed of. They would only really need testing if the resident was being prosecuted for them or if it was needed for proof for a recall. The programme also failed to mention the full span of control an AP manager has - all referrals, allocations, supervision of all staff, building manager, health and safety lead are just the tip of the iceberg. No workload measurement tool in APs. Oh and don't forget on call, where they may have to do a 12 hour night shift after a day's work.

The institutional appearance of the AP, along with the worst Facilities Management contract ever, means most AP buildings are unfit for purpose so staff work extra hard to make a residents stay as good as it can be. 

It's normal to let off steam in the office - no one expects to be recorded. AP staff work really hard. Where else would someone work a 12 hour shift without an official break? Men on 6 man lockdown in custody are brought to the door and left with 2 staff without a thought.

We aren't mental health practitioners but deal with residents that have serious diagnoses linked to risk. Then there's drug and alcohol testing. Vital for our duty of care, especially when giving out medication, but they stopped the instant mouth swab tests in favour of more expensive, more reliable urine tests, where you wait a week for the results. Now we can't even use those regularly due to the cost.

I could go on talking about the issues but I want to say that an AP is also one of the best places to work. You can spend meaningful time with residents and get to know some of them. Some residents have never had anyone who asked about their day or to share advice with. PPs are too busy and overworked to have time to get to know them properly and we can share valuable insights - both good and bad.

Despite everything I am proud to work at an AP and my colleagues feel the same. We may be the forgotten part of the service but that doesn't mean we don't perform our roles to our best ability.

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Now we know the subject of the Panorama programme is a PIPE - and I have to say I hate this fetish civil servants have with giving everything stupid acronyms - we need to say something about them. This from Prison Reform Trust published by InsideTime is a good summary:-

We get regular calls asking us for information about ‘PIPE’ units, often after the possibility of a referral has come up in discussion with staff. PIPEs, which stands for ‘Psychologically Informed Planned Environments’, are residential environments which are specifically designed to support the progression of people with complex needs and personality related difficulties. They are part of the Offender Personality Disorder Pathway (OPDP) which is a connected set of interventions for people who are likely to meet the criteria for a diagnosis of personality disorder. It is important to note that a diagnosis of personality disorder is not required to be considered eligible for referral to a PIPE.

PIPEs are designed to have a focus on the environment in which they operate; recognising the importance and quality of relationships and interactions. They aim to maximise ordinary situations and to approach these in a psychologically informed way, paying attention to interpersonal difficulties, such as those issues that might be linked to personality disorder. Overall, PIPEs aim to improve the psychological health of participants, improve participants’ quality of relationships and relationship skills, and reduce the likelihood of reoffending.

The PIPE model incorporates some core components which are designed to support and develop individuals living and working within them. Staff working in a PIPE have additional training and clinical supervision to give them a better psychological understanding of their work. This understanding helps them to create a safer and more supportive environment, which can facilitate the development of those who live there. PIPEs will offer both ‘structured’ sessions and less formal ‘socially creative’ sessions in order to provide opportunities for relating and addressing issues that may be affecting progression through the pathway. Regular key worker sessions are also a core part of the model, providing an opportunity to coordinate and reflect upon your involvement on the PIPE, and your plans for the future.

In prison, a PIPE should be housed on a discreet unit, where influences from non-PIPE prisoners, and contact with non-PIPE trained/supported staff, is kept to a minimum. Residents may have to engage with the rest of the prison for activity such as employment or workshops but otherwise contact with non-PIPE staff/residents should be kept to a minimum to help contain and sustain the PIPE environment.

There are four different types of PIPE, each type with a different focus. Whilst some individuals do move from one type of PIPE to another, this is not always the case, or the expectation. There is not a ‘best time’ to go onto a PIPE unit as each person’s circumstances and sentence plan will be different.

Preparation: PIPEs focus on increasing motivation and readiness for the next phase of the pathway, whilst exploring any barriers there might be to treatment.

Provision: PIPEs are designed to provide a supportive environment to increase engagement with treatment activity, and support residents to actively apply skills and learning achieved through this treatment.

Progression: PIPEs are designed to support residents in consolidating and generalising their treatment gains, putting new skills into practice, and demonstrating improvements in behaviour.

In the community there are also ‘Approved Premises PIPEs’ which take a whole-premises approach to support effective community reintegration and resettlement.

At the time of writing there are 15 PIPE units in the men’s prison estate, located in category A, B & C establishments, and 3 PIPE units in the women’s estate. There is also a further 10 PIPE Approved Premises in the community, 3 of which are for women.

Individual suitability for a PIPE should be discussed with your Offender Manager, your key worker, or a psychologist in the first instance. They can then liaise with Units on your behalf and assist with the referral process.

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This from 2014 was probably just aspirational:-

A guide to Psychologically Informed Planned Environments (PIPEs) 

Since 2010 the Department of Health (DH) and the National Offender Management Service (NOMS), in consultation with a team of clinicians, have jointly developed a new initiative now widely known as PIPEs, or Psychologically Informed Planned Environments. NOMS and NHS England are now in the process of commissioning PIPE services within the Criminal Justice System to support the progression of offenders with complex needs and personality related difficulties. 

PIPEs are specifically designed, contained environments where staff members have additional training to develop an increased psychological understanding of their work. This understanding enables them to create an enhanced safe and supportive environment, which can facilitate the development of those who live there. They are designed to have a particular focus on the environment in which they operate; actively recognising the importance and quality of relationships and interactions. They aim to maximise ordinary situations and to approach these in a psychologically informed way, paying attention to interpersonal difficulties, for example those issues that might be linked to personality disorder.

Approved Premises PIPE

A whole‐premises approach, focussing on a psycho‐social understanding of residents, and supporting effective community re‐integration and resettlement. PIPE Approved Premises will integrate PIPE model requirements into the core functions of the premises and aim to provide new experiences and pro‐social opportunities for its residents. The population will include a range of offenders at different stages of the pathway, for example a mix of those who have completed interventions and those who have not. The models above could be adapted to be delivered in a community setting, focussing on a specific population if required.

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Letter to InsideTime 2013:-

I am an IPP prisoner that was released in December 2022 to a PIPE hostel. This meant waiting six months inside even after the Parole Board granted release.

I got to the hostel and for those that don’t know the PIPE system, it is meant to give you more support, often to those with personality disorders. I spent six months there and found it very supportive. The staff were really good. Like everything probation-related, it’s not perfect but it’s a start.

I have no family support or network and the staff, being aware of this, make it clear that when you leave the hostel to move on they are still there to support you. This gave me a bit more confidence when I moved, as I knew should I need help I could ask. However, I have now been banned by my probation officer from contacting the hostel as “when you leave, you’re supposed to move on”.

Now considering I had to wait to get into PIPE, you would think probation would know how it works and want me to make the most of the support available. No, not the case. Now, after 12 years inside and doing all those courses they insist you do about support networks and building relationships, I am sat alone in my own place seeing my probation officer for 20 minutes a week. The rest of the time I’m sitting alone, as I am not allowed to use the support network that consisted of professionals because probation says so.

So can anyone tell me the point of the PIPE, as the support it was meant to give is not allowed by the organisation that created it.

A former prisoner