Plain English Summary
Background and study aims
The study aims to determine whether a new out of court programme, named Gateway, improves the health and well-being of young adult offenders aged 18-24, and influences their chance of offending again. Young adult offenders commonly have a range of health and social needs, making them vulnerable to mental health problems. If they are aged between 18-24 years old and have committed a crime, they may need to attend court and face convictions such as prison. However, many believe that more should be done to prevent young adults from entering prison in the first place. The Gateway programme has been developed by Hampshire Constabulary and the Hampton Trust, in partnership with local community groups, with an aim to improve the life chances of young adult offenders. In the programme, a mentor assesses the needs of each adult and develops a care pathway with referrals to healthcare. The young adult offenders then attend two workshops about empathy, and the causes and consequences of their behaviour. Such programmes are believed to improve the health and well-being of young offenders, and reduce criminal behaviour. However, there is currently little information about how well they work.
Who can participate?
18-24 year-old offenders who have been arrested for at least a second time for a low level criminal offence
What does the study involve?
Once charged with an offence at Southampton police station, the participants are randomly allocated to either take part in the Gateway programme, or to not take part and be given a court conviction. To compare whether the Gateway programme is more (or less) effective at improving their outcomes, participants are followed up for two years. Their outcomes are compared at different time points. Specifically, differences in mental health and well-being, quality of life, criminal behaviour, access to health and social care and substance abuse are studied. Some are asked to participate in restorative justice, which is a meeting between the offender and the victim. The offender has the opportunity to discuss and make amends for the crime they committed. To explore how satisfied the victims are with this, and on Gateway in general, victims are also interviewed. To understand what works, where and for whom, further interviews are undertaken with groups delivering the programme in other counties. Furthermore, to understand how costly the programme is, the costs spent through each group, as well as the associated health improvements, are compared.
What are the possible benefits and risks of participating?
The main benefit from this study will be in helping to add to the knowledge about this programme, and whether it helps young adults who otherwise would face a court conviction. Following completion of each dataset, the University of Southampton will provide participants with a supermarket voucher to encourage retention in this population. It is possible that some participants may find it upsetting to talk about their individual circumstances and issues. For those allocated to the Gateway programme, analysing own previous behaviour or meeting the victim may be emotionally upsetting.
Where is the study run from?
Southampton Central Police Station (UK)
When is the study starting and how long is it expected to run for?
March 2018 to July 2021
Who is funding the study?
National Institute for Health Research (UK)
Who is the main contact?
Mrs Alison Booth
Protocol version 1.3 16 April 2018
Gateway: a randomised controlled 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 young adult offenders; victim satisfaction and reducing recidivism
It is hypothesised that the Gateway intervention will have a beneficial effect on the health and well-being (including alcohol and substance use), access to health and social services and quality of life for young adults who re-offend for low level criminal offences.
1. The Hampshire Constabulary Ethics Department, 16/03/2018
2. University of Southampton Ethics and Research Governance Board - approval pending
The trialists obtained confirmation that ethical review by an NHS REC, HMPPS (NOMS) or The Social Care REC were not necessary
Single-site pragmatic randomised controlled trial with an embedded economic evaluation and qualitative study
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Not available in web format, please use the contact details to request a participant information sheet
The study population of interest are 18-24 year-old offenders who have been arrested for at least a second time for a low level criminal offence. According to police statistics, the five main categories are: violence; possession or trafficking of drugs; theft; criminal damage; and public order offences. These young adults represent a vulnerable population with a range of complex needs, such as mental health issues and drug and substance misuse. They are more likely to come into contact with the police both as suspects and victims of crime and are significantly over represented in the formal justice process, accounting for approximately one-third of police, probation and prison caseloads
Once charged with an offence at Southampton police station, the consenting participants will be allocated to either the intervention group or the control group by chance using a computer program.
Gateway is an out-of-court community based intervention (OCBI) with three components: assessing health and social care needs (triaging) and mentoring; empathy workshops; and restorative justice conferencing. The programme therefore addresses several risk and protective factors, thereby aiming to promote health and well-being for the individual and supporting desistence.
Participants randomised to the control group will receive routine disposal; that is they will be discharged from the police station to await a date for their court appearance where they will receive the judgement of the court.
To compare whether the Gateway programme is more (or less) effective at improving their outcomes, as compared to court conviction, participants will be followed up for two years. Their outcomes will be compared at different time points. Specifically, differences in mental health and well-being, quality of life, criminal behaviour, access to health and social care and substance abuse will be studied. To explore how satisfied the victims were with this, and on Gateway in general, victims will also be interviewed. To understand what works, where and for whom, further interviews will be undertaken with groups delivering the programme in other counties. Furthermore, to understand how costly the programme is, the costs spent through each group, as well as the associated health improvements, will be compared.
Primary outcome measures
Mental health and well-being measured using the Warwick-Edinburgh Mental Health and Well-being Scale (WEMWBS) at 4 weeks, 16 weeks and 1 year post randomisation
Secondary outcome measures
The following secondary outcomes will be measured at 4 weeks, 16 weeks and 1 year post randomisation:
1. Mental and physical functioning and overall health-related-quality of life measured using SF-12
2. Risky alcohol use measured using the Alcohol Use Disorders Identification Test (AUDIT)
3. Drug use measured using the Adolescent Drug Involvement Scale (ADIS)
4. Data on resource use, including access to primary and secondary care health services and social care, gathered using the Client Service Receipt Inventory (CSRI), primarily to inform the economic evaluation
5. Re-offending type and frequency from routinely collected police data
6. Mortality and morbidity, from routine data for patient admission statistics (PAS)
1. The Adverse Childhood Experiences (ACE) questionnaire administered at 16 weeks only
Overall trial start date
Overall trial end date
Participant inclusion criteria
1. Offenders within the Southampton district policing area aged 18-24 years who accept responsibility for an offence in accordance with National Police Chiefs’ Council (NPCC) Guidelines for Community Resolution
2. Case where there is sufficient evidence to meet the Crown Prosecution Service Full Code Test 1 (Evidential standard)
3. 18 year olds that have previously been engaged by Southampton Youth Offender Service with community based orders in the last 12 months
Target number of participants
Participant exclusion criteria
1. Hate crime according to Crown Prosecution Services (CPS) Policy
2. Domestic violence related crime dealt with under Project CARA (community intervention)
3. Domestic violence related crime referred to CPS
4. Offenders suitably dealt with by way of Community Caution as an immediate disposal
5. Where on conviction the court is more likely to impose a custodial sentence (based on sentencing guides)
6. Any offenders currently under multi-agency public protection arrangement (MAPPA) case management
7. Breach of court or sexual offences orders
8. Any offence involving a death of another
9. Offences under terrorism or official secrets legislation
10. Indictable only offences
11. All drink drive offences
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Southampton Central Police Station
Hampshire Constabulary Southern Road
University of Southampton
National Institute for Health Research
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
The study protocol will be made freely available on the NIHR PHR project page: https://www.journalslibrary.nihr.ac.uk/programmes/phr/1612220/#/. The study results will be written in a formal report as well as a short summary report, which will be written so that it is easily understood by the public. The study findings will also be shared with all groups and partners involved in the study, including the offender and victim groups, the Public Participation Panel, academics and policy-makers locally and nationally.
IPD sharing statement
The trial dataset will be held at York Trials Unit. Access will be considered on a case by case basis following completion of the trial.
Intention to publish date
Participant level data
Available on request
Results - basic reporting