Addressing Reoffending Through Addressing Offender Mental Health: Exploring the viability of the Change Laboratory method as means of promoting social innovation in the delivery of integrated mental health care offenders in prison services

Authors

Päivikki Lahtinen; Terhi Esko; Anu Kajamaa; Berit Johnsen; Laura Seppänen; Sarah Hean

Synopsis

Recidivism rates are a typical measure of the success of the criminal justice system. Effective collaboration is required between criminal justice services and mental health services to effectively achieve offender rehabilitation and reduce reoffending. Previous work on collaborative practice in the Norwegian prison systems (Hean et al., 2016) has concluded that more effective models of collaboration are required between the mental health and criminal justice services.


It made the case for implementation of the Change Laboratory Method (CL) of interagency working and workforce transformation as a means of supporting interagency collaborative practice in this context. The CL has been used successfully and extensively by researchers internationally to transform interagency working practices in a wide range of countries (e.g., Finland, Brazil; New Zealand) and contexts (e.g. child protection, secondary health care and business) with an extensive list of products and work transformations arising from them (e.g. new adaptations of care pathways, new forms of service delivery) (Kerosuo & Engeström, 2003, Warmington et al., 2005, Tolviainen, 2007, Virkkunen et al., 2014).


However, CLs as interventions are a new idea in Norwegian prison development, none as yet having been applied across organisational borders or specifically to the challenges facing collaboration between correctional and health and welfare services. It is essential therefore to explore first the feasibility of the such a possible intervention before implementation. The aim of this developmental project was therefore to conduct first the ethnographic phase of a CL intervention in a case study Norwegian prison, and identify issues that would benefit from future intervention, organizational development and learning. Second, the project explored the viability of the CL as a means of addressing these and improving collaboration between Correctional and Mental Health Services.


The purpose of the first CL phase is for the interventionist team to describe the current situation of collaboration in the prison. The focus was to reveal challenges (theoretically described as contradictions) by seeing them as systemic causes of problems in collective activity instead of indications of individuals’ actions. Data from the first CL phase was gathered through interviews, observations and documentary data from an open department at the prison in Region West of the Norwegian Correctional Services. A cultural-historical activity theory approach guided the methods of data collection and analysis. This meant that the collaborative tools and voices of frontline workers, such as officers and mental health workers were brought to the fore. The analysis illustrated the complexity of the collaboration network in the prison, its variety of actors, and its challenges.


This report presents the characteristics of current collaboration practices, examples of good practice as well as its challenges, and the complexity of the collaboration network between the mental health and prison services. These collaboration practices have developed with an aim to enhance the welfare of offenders and to reduce recidivism. However, the increasing needs of offender, of which loneliness and mental health were central, have come into play, which challenges the outputs of the services and collaboration between service providers.


We report here three potential contradictions for future exploration by the prison that arose from the analysis. The first pertained to the challenges facing the BRIK assessment tool. BRIK is a tool used in the prison through which information on offender’s needs and resources are collected and evaluated by the officer and offender together. However, a lack of time to keep the content of BRIK regularly updated and ensuring the quality of its content ,is a challenge. In the report, we suggest that these challenges are connected to the fact that users of the tool (members of interagency meetings, offenders and officers) perceive the meaning and purpose of BRIK differently. For offenders, BRIK represents a tool to get more face-to-face time with the officer, which points to the inmate’s need of having more social contact. However, for the officer BRIK is one of their work tasks, a task required of them by Correctional Services authorities.


For members of interagency meetings with health and other services, however, BRIK is a tool for understanding an offender’s motivation behind any specific request they might make of the meeting. This contradiction between different needs and meanings of purpose of BRIK challenges the effective use of the instrument. The second contradiction lay in observations that the prison officer`s purpose of work has changed over time but the development of tools to support their work has not kept up with these changing objectives. The third contradiction pertained to the suboptimal work organization, development, and flow of psychological knowledge in the prison.


The purpose of this ethnographic phase of the CL presented in this report is not to fully elaborate these above contradictions collected by researchers as it essential to the model that these are articulated and understood by the prison, mental health and other prison based actors themselves when participating in future interventions. The contradictions raised by the ethnographic phase must be further revealed within this group of actors working together. Based on the potential contradictions raised in the ethnographic phase of the CL we now recommend a second phase of the CL in which our observations and findings of the collaborative network would be presented as mirror data to representatives of this network.


This next phase would seek to open up new perspectives and motivate people in the prison to examine and develop their current practices further and collectively. During the process of CL, the organization would learn to solve their own contradictions and develop their activity. However, to ensure the implementation of this second phase ,careful negotiation, sensitivity and commitment of the researchers, prison management and frontline professionals involved, is required.

Author Biographies

Päivikki Lahtinen

Researcher and PhD candidate
Faculty of Educational Sciences
University of Helsinki
paivikki.lahtinen@helsinki.fi

Terhi Esko

Researcher and PhD candidate
Faculty of Educational Sciences
University of Helsinki
terhi.esko@helsinki.fi

Anu Kajamaa

Adjunct Professor
Faculty of Educational Sciences
University of Helsinki
anu.kajamaa@helsinki.fi

Berit Johnsen

Head of Research Department
University College of Norwegian Correctional Service
berit.johnsen@krus.no

Laura Seppänen

Chief Scientist
Finnish Institute of Occupational Health
laura.seppanen@ttl.fi

Sarah Hean

Professor
Social work and Social Sciences
University of Stavanger
sarah.c.hean@uis.no

References

Berkenkotter. C. & Ravotas, D (1997) Genre as Tool in the Transmission of Practice Over Time and Across Professional Boundaries, Mind, Culture, and Activity, 4:4, 256-274, DOI: 10.1207/s15327884mca0404_4

https://doi.org/10.1207/s15327884mca0404_4

Bjerkan, J., Richter, M. & Grimsmo, A.(2011) Integrated care in Norway: State of affairs years after regulation by law. Journal of Integrated Care Vol. 11.

https://doi.org/10.5334/ijic.530

Bodrožić, Z. (2008). Post-Industrial Intervention: An Activity-Theoretical Expedition Tracing the Proximal Development of Forms of Conducting Interventions. University of Helsinki, Department of Education, Research Report 220 (Doctoral dissertation): Helsinki University Press.

Helse og Omsorg Departement., (2013). (Departement i Helse og Omsorg Departement) Morgendagens omsorg: Norwegian Governement White Paper no. 29.

Department of Health. (2010) Equity and Excellence: Liberating the NHS.

Engeström, Y. (1987). Learning by Expanding: an Activity-theoretical Approach to Developmental Research. Helsinki; Orienta-Konsultit.

Engeström, Y. (2000). Activity Theory and the Social Construction of Knowledge: A Story of Four Umpires. Organization 7(2), 301-310.

https://doi.org/10.1177/135050840072006

Engeström, Y. (2004) "New forms of learning in co‐configuration work", Journal of Workplace Learning, Vol. 16 Issue: 1/2, pp.11-21, https://doi.org/10.1108/13665620410521477

https://doi.org/10.1108/13665620410521477

Engeström, Y. (2005) Knotworking to Create Collaborative Intentionality Capital in Fluid Organizational Fields. Advances in Interdisciplinary Studies of Work Teams,(11), 307-336.

https://doi.org/10.1016/S1572-0977(05)11011-5

Engeström, Y. (2007). Putting Vygotsky to work: The change laboratory as an application of double stimulation. In H. Daniels, M. Cole & J. V. Wertsch (Eds.), The Cambridge companion to Vygotsky (pp. 363-382). Cambridge, UK: Cambridge University Press.

https://doi.org/10.1017/CCOL0521831040.015

Engeström, Y. (2008). From Teams to Knots: Activity-Theoretical Studies of Collaboration and Learning at Work (Learning in Doing: Social, Cognitive and Computational Perspectives). Cambridge: Cambridge University Press. doi:10.1017/CBO9780511619847

https://doi.org/10.1017/CBO9780511619847

Engeström, Y. & Sannino, A. (2011). Discursive manifestations of contradictions in organizational change efforts: a methodological framework. Journal of Organizational Change Management 24 (3), 368-387.

https://doi.org/10.1108/09534811111132758

Engeström, Y. Rantavuori. J. and Kerosuo, H. (2013). Expansive Learning in a Library: Actions, Cycles and Deviations from Instructional Intentions. Vocations and Learning, 6:81. doi.org/10.1007/s12186-012-9089-6

https://doi.org/10.1007/s12186-012-9089-6

Engeström, Y., Virkkunen, J., Helle, M., Pihlaja, J., & Poikela, R. (1996). The Change Laboratory as a tool for transforming work. Lifelong Learning in Europe, 1(2), 10-17.

Esko, T. & Lahtinen, P. (2018). "Contradiction in correctional services." Presented in FERA conference 15.11.2018, Tampere, Finland.

Fazel, S. & Danesh, J. (2002). Serious mental disorder in 23000 prisoners: a systematic review of 62 surveys. Lancet 359, 545-50.

https://doi.org/10.1016/S0140-6736(02)07740-1

Goel, A. & Yang, N. (2015) Article Information: 1-6 . doi:10.1108/EL-01-2014-0022

https://doi.org/10.1108/EL-01-2014-0022

Hean, S., Willumsen, E. & Ødegård, A. (2016). COLLABORATION: Marie Curie Action-Individual intra European felllowship. at <(http://cordis.europa.eu/project/rcn/188119en.html)

Hean, S., Willumsen, E. and Ødegård, A., (2017a). Collaborative practices between correctional and mental health services in Norway: Expanding the roles and responsibility competence domain. Journal of Interprofessional Care, 31 (1), 18-27.

https://doi.org/10.1080/13561820.2016.1233392

Hean, S., Willumsen, E. and Ødegård, A., (2018). Making sense of interactions between mental health and criminal justice services: the utility of cultural historical activity systems theory. International Journal of Prisoner Health, 14 (2), 124-141.

https://doi.org/10.1108/IJPH-01-2017-0006

Hean, S., Ødegård, A. and Willumsen, E., (2017b). Improving collaboration between professionals supporting mentally ill offenders. International Journal of Prisoner Health, 13 (2), 91-104.

https://doi.org/10.1108/IJPH-12-2016-0072

Johansson, R. (2003): Case Study Methodology. A Key note speech at the international conference "Methodologies in Housing Research" organized by the Royal Insitute of Technology in cooperation with International Association of People-Environment Studies, Stockholm, 22-24 September 2003.

Justis og beredskapsdepartementet (2017) Redusert tilbakefall til ny kriminalitet. Nasjonal strategi for samordnet tilbakeføring etter gjennomført straff 2017-2021.

Kajamaa, A. & Schultz, K-P. (2018). From the abstract to the concrete: Implementation of an innovative tool in home care. Health Services Management Research Journal 31(1), 2-10.

https://doi.org/10.1177/0951484817724581

Kajamaa, A. (2011). Unraveling the helix of change: An activity-theoretical study of health care change efforts and their consequences. (An article based Doctoral dissertation) Helsinki: Unigrafia.

Kajamaa, A. & Lahtinen, P. (2016). Carnivalization as a new mode of collaboration. Journal of Workplace Learning 28(4): 188-205.

https://doi.org/10.1108/JWL-11-2015-0084

Kerosuo, H. & Engeström, Y. (2003). Boundary crossing and learning in creation of new work practice. J. Work. Learn. 15, 345-351.

https://doi.org/10.1108/13665620310504837

Kerosuo, H., Kajamaa, A., and Engeström, Y. (2010). Promoting innovation and learning through Change Laboratory: An example from Finnish Health care. Central European Journal of Public Policy, 4(1), 110-131.

Kodner, D. & Spreeuwenberg, L. C. Integrated care: meaning, logic, applications, and implications - a discussion paper. Int. J. Integr. Care 2, 1-6 (2002).

https://doi.org/10.5334/ijic.67

Lahtinen P. & Esko T. (2018). Findings of COLAB project. Presented in COLAB seminar 4.9.2018, Lillestrøm, Norway

Laine, M., Bamberg, J. & Jokinen, P. (eds.)(2002):Tapaustutkimuksen taito. Gaudeamus 2008 (2. edition)

Langeveld, H. and Melhus, H. (2004) Are psychiatric disorders identified and treated by in-prion health services? Journal Tidsskrift for den Norske laegeforening: tidsskrift for Praktisk Medicin. 124(16), 2094-2097.

Leont'ev, A. N. (1978). Activity, Consciousness and Personality. Englewood Cliffs, New Jersey: Prentice-Hall.

Marcus, G. E. (1995) Ethnography in/of the world system: The emergence of multi-sited ethnography. Annual Review of Anthropology 24(1), 95-117.

https://doi.org/10.1146/annurev.an.24.100195.000523

Marcus, G. E. (1998). Ethnography through thick and thin. Princeton, NJ: Princeton University Press.

Rowley, J. (2002): Using Case studies. Management Research News. Volume 25 (1).

https://doi.org/10.1108/01409170210782990

Toiviainen, H. (2007). Interorganisational leaning across levels: an object orientate approach. J. Work. Learn. 19, 343-358.

https://doi.org/10.1108/13665620710777093

Virkkunen, J., and Newnham, D. S. (2013). The Change Laboratory. A Tool for Collaborative Development of Work and Education. Rotterdam: Sense Publishers.

https://doi.org/10.1007/978-94-6209-326-3

Virkkunen, J., Vilela, R. A. de G., Querol, M. A. P. & Lopes, M. G. R. (2014) O Laboratório de Mudança como ferramenta para transformação colaborativa de atividades de trabalho: uma entrevista com Jaakko Virkkunen. Saúde e Soc. 23, 336-344.

https://doi.org/10.1590/S0104-12902014000100027

Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, Mass.: Harvard University Press.

Warmington, P. Daniels, H., Edwards, A., Brown, S., Leadbetter, J., Martin, D., Middleton, D., Parsons, S. and Popova, A. (2005). Learning in and for interagency working: a developmental work research intervention. 4th Int. Conf. Res. Work Learn. 1-10.

World Health Organisation. Global Strategy on People-centred and Integrated Health Services. (WHO, 2015). at <http://www.who.int/servicedeliverysafety/areas/people-centred-care/en/>

Cover for Addressing Reoffending Through Addressing Offender Mental Health: Exploring the viability of the Change Laboratory method as means of promoting social innovation in the delivery of integrated mental health care offenders in prison services
Published
November 11, 2019