Completed Mental Health Public Health & Healthcare

Gateway: A randomised control trial, economic and qualitative evaluation to examine the effectiveness of an out-of-court community-based Gateway intervention programme aimed at improving health and well-being for youth offenders; victim satisfaction and reducing recidivism

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Every year, youth offenders in England cost society an estimated £19 billion. A new trial will test whether a community-based programme called Gateway can improve the health and wellbeing of 18-to-24-year-old offenders, reduce reoffending, and satisfy victims, while saving money. The problem is that young adult offenders often have complex needs—mental health issues, substance misuse, housing and job problems—yet the evidence for out-of-court community interventions remains weak. The Harris Review (2015) called for more diversion from the criminal justice system, but policymakers lack robust data on what works. This trial will randomly assign 334 participants in Southampton to Gateway or standard processing, tracking mental health, quality of life, drug and alcohol use, and reoffending over two years. If Gateway proves effective, it could shift how the criminal justice system handles young adults. Instead of entering custody—where self-harm and suicide risks are high—offenders would receive targeted health and social care, plus workshops on offending behaviour and empathy. The embedded economic evaluation will show whether the programme cuts the £19 billion annual burden. For funders and commissioners, the results offer a rare chance to base diversion policy on hard evidence rather than assumption.

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Background: Young adult offenders represent a vulnerable population with a range of complex and overlapping needs, such as mental health issues, substance misuse and difficulties securing accommodation and employment. The Harris Review on self-inflicted deaths in custody amongst 18-24 year-olds (2015) calls for more to be done to divert young adults from entering the criminal justice system, as well as increased availability of child and adolescent mental health services, and earlier prevention in the community. Despite an increased acknowledgement of the role of out-of-court community based interventions (OCBIs) and diversion, and their impact on the health and well-being of young adult offenders, the evidence base is still underdeveloped. Furthermore, there is a need to examine the potential cost savings, with the current social and economic costs of youth offenders in England being estimated at around £19 billion a year. Study design: The proposed study is a single-site pragmatic randomised controlled trial, which uses mixed methods, including embedded economic and qualitative evaluations. The aim of the study is to examine the effectiveness of an OCBI known as‘ Gateway’ on improving health and well-being of offenders aged 18-24, as well as reducing recidivism and improving victim satisfaction. Approximately 334 participants from Southampton will be assessed at four time points over a two-year period for changes in mental health and well-being (primary outcome), as well as quality of life, alcohol and drug use, resource use and recidivism (secondary outcomes). The Gateway programme is a police-led and funded intervention, with a multi-agency approach. It aims to engage it’s participants with specialised health and social care services, and incorporates two workshops focusing on understanding offending behaviour, developing empathy and addressing the wider determinants of reoffending, such as substance misuse and housing problems. Impact of study: The results of this study will inform practice of relevant services and agencies, and add to the knowledge base on diversion initiatives. The evidence on the programme’s cost-effectiveness, and barriers and facilitators to its implementation will be used to improve the Gateway intervention, as well as in designing future similar initiatives, much needed by the young people themselves, their families and community, and society as a whole.

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