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Examining the effectiveness of the Gateway conditional caution on health and well-being of young adults committing low-level offences: a randomised controlled trial

Examining the effectiveness of the Gateway conditional caution on health and well-being of young adults committing low-level offences: a randomised controlled trial
Examining the effectiveness of the Gateway conditional caution on health and well-being of young adults committing low-level offences: a randomised controlled trial

BACKGROUND: Young adults who commit low-level offences commonly have a range of health and social needs and are significantly over-represented in the criminal justice system. These young adults may need to attend court and potentially receive penalties including imprisonment. Alternative routes exist, which can help address the underlying causes of offending. Some feel more should be done to help young adults entering the criminal justice system. The Gateway programme was a type of out-of-court disposal developed by Hampshire Constabulary, which aimed to address the complex needs of young adults who commit low-level crimes. This study aimed to evaluate the effectiveness and cost-effectiveness of the Gateway programme, issued as a conditional caution, compared with usual process.

METHODS: The Gateway study was a pragmatic, parallel-group, superiority randomised controlled trial that recruited young adults who had committed a low-level offence from four sites covering Hampshire and Isle of Wight. The primary outcome was mental health and well-being measured using the Warwick-Edinburgh Mental Well-being Scale. Secondary outcomes were quality of life, alcohol and drug use, and recidivism. Outcomes were measured at 4, 16 and 52 weeks postrandomisation.

RESULTS: Due to issues with retention of participants and low data collection rates, recruitment ended early, with 191 eligible participants randomised (Gateway 109; usual process 82). The primary outcome was obtained for 93 (48.7%) participants at 4 weeks, 93 (48.7%) at 16 weeks and 43 (22.5%) at 1 year. The high attrition rates meant that effectiveness could not be assessed as planned.

CONCLUSIONS: Gateway is the first trial in a UK police setting to have a health-related primary outcome requiring individual data collection, rather than focusing solely on recidivism. We demonstrated that it is possible to recruit and randomise from the study population, however follow-up rates were low. Further work is needed to identify ways to facilitate engagement between researchers and vulnerable populations to collect data.

TRIAL REGISTRATION NUMBER: ISRCTN11888938.

0959-8138
Mitchell, Alex
068b4348-a75e-45da-a582-65c866bb95ab
Booth, Alison
15f47c11-9982-474c-8cbd-db0196ca8179
Morgan, Sara
8ad10b7e-2005-4e93-9948-164a69489350
Walker, Inna
1f0cff2f-26a7-4952-b879-7df0df5a27d5
Chapman, Caroline
36c49889-28a6-4bb0-93a3-45467596a7a3
Barlow-Pay, Megan
d968b486-d518-4509-9be4-c604171c81b8
Cochrane, Ann
da5c7ab9-4218-4577-9446-566d392619dd
Filby, Emma
aaad5dc2-86e6-4e91-ba4f-6099d81e1011
Fleming, Jenny
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Hewitt, Catherine
00d4b287-83b3-4f8e-a117-b26451eb7f61
Raftery, James
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Torgerson, David
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Weir, Lana
be59f5c1-3aa7-4712-b3a9-1b4b8b1b1b62
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Mitchell, Alex
068b4348-a75e-45da-a582-65c866bb95ab
Booth, Alison
15f47c11-9982-474c-8cbd-db0196ca8179
Morgan, Sara
8ad10b7e-2005-4e93-9948-164a69489350
Walker, Inna
1f0cff2f-26a7-4952-b879-7df0df5a27d5
Chapman, Caroline
36c49889-28a6-4bb0-93a3-45467596a7a3
Barlow-Pay, Megan
d968b486-d518-4509-9be4-c604171c81b8
Cochrane, Ann
da5c7ab9-4218-4577-9446-566d392619dd
Filby, Emma
aaad5dc2-86e6-4e91-ba4f-6099d81e1011
Fleming, Jenny
61449384-ccab-40b3-b494-0852c956ca19
Hewitt, Catherine
00d4b287-83b3-4f8e-a117-b26451eb7f61
Raftery, James
bc971b3e-7038-4093-8669-46a88e261244
Torgerson, David
a8362276-44d5-4b61-ab59-f0d886018456
Weir, Lana
be59f5c1-3aa7-4712-b3a9-1b4b8b1b1b62
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984

Mitchell, Alex, Booth, Alison, Morgan, Sara, Walker, Inna, Chapman, Caroline, Barlow-Pay, Megan, Cochrane, Ann, Filby, Emma, Fleming, Jenny, Hewitt, Catherine, Raftery, James, Torgerson, David, Weir, Lana and Parkes, Julie (2024) Examining the effectiveness of the Gateway conditional caution on health and well-being of young adults committing low-level offences: a randomised controlled trial. British Medical Journal, 14 (4), [e081179]. (doi:10.1136/bmjopen-2023-081179).

Record type: Article

Abstract

BACKGROUND: Young adults who commit low-level offences commonly have a range of health and social needs and are significantly over-represented in the criminal justice system. These young adults may need to attend court and potentially receive penalties including imprisonment. Alternative routes exist, which can help address the underlying causes of offending. Some feel more should be done to help young adults entering the criminal justice system. The Gateway programme was a type of out-of-court disposal developed by Hampshire Constabulary, which aimed to address the complex needs of young adults who commit low-level crimes. This study aimed to evaluate the effectiveness and cost-effectiveness of the Gateway programme, issued as a conditional caution, compared with usual process.

METHODS: The Gateway study was a pragmatic, parallel-group, superiority randomised controlled trial that recruited young adults who had committed a low-level offence from four sites covering Hampshire and Isle of Wight. The primary outcome was mental health and well-being measured using the Warwick-Edinburgh Mental Well-being Scale. Secondary outcomes were quality of life, alcohol and drug use, and recidivism. Outcomes were measured at 4, 16 and 52 weeks postrandomisation.

RESULTS: Due to issues with retention of participants and low data collection rates, recruitment ended early, with 191 eligible participants randomised (Gateway 109; usual process 82). The primary outcome was obtained for 93 (48.7%) participants at 4 weeks, 93 (48.7%) at 16 weeks and 43 (22.5%) at 1 year. The high attrition rates meant that effectiveness could not be assessed as planned.

CONCLUSIONS: Gateway is the first trial in a UK police setting to have a health-related primary outcome requiring individual data collection, rather than focusing solely on recidivism. We demonstrated that it is possible to recruit and randomise from the study population, however follow-up rates were low. Further work is needed to identify ways to facilitate engagement between researchers and vulnerable populations to collect data.

TRIAL REGISTRATION NUMBER: ISRCTN11888938.

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e-pub ahead of print date: 11 April 2024
Published date: 25 April 2024
Additional Information: Publisher Copyright: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.

Identifiers

Local EPrints ID: 489758
URI: http://eprints.soton.ac.uk/id/eprint/489758
ISSN: 0959-8138
PURE UUID: bab31bdb-6048-4dc8-994e-5dff725cde22
ORCID for Jenny Fleming: ORCID iD orcid.org/0000-0002-7913-3345
ORCID for Julie Parkes: ORCID iD orcid.org/0000-0002-6490-395X

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Date deposited: 02 May 2024 16:31
Last modified: 06 Jun 2024 01:50

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Contributors

Author: Alex Mitchell
Author: Alison Booth
Author: Sara Morgan
Author: Inna Walker
Author: Caroline Chapman
Author: Megan Barlow-Pay
Author: Ann Cochrane
Author: Emma Filby
Author: Jenny Fleming ORCID iD
Author: Catherine Hewitt
Author: James Raftery
Author: David Torgerson
Author: Lana Weir
Author: Julie Parkes ORCID iD

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