If you had to explain to someone who doesn’t know this method very well what case management is, what would you tell them?
It is a method of social work that we use with clients who have multiple problems or where the depth of their problems causes them to need more intensive support. Social workers, case managers who go to prisons, meet clients there. In our case, clients usually have a combination of addictions and other social problems, such as unstable housing, insecure finances, and debt, as well as health and relationship problems. Case managers try to find out from them what they themselves consider complicated in their situation, what they would like to do, and what they would like to change in their lives. They then look for ways to plan such things, how to prepare them, and who else can help them with the solution. Often, such extensive problems cannot be solved by just one worker of one service, and it is necessary to recruit other professionals from other fields. The role of the case manager is to coordinate the provision of this professional help and support and to be supportive of the client, motivating them to be persistent in their efforts. They also try to reflect on what has been successful. Many clients manage the important steps of their lives, but they often take them for granted.
Being aware of the client’s achievements and what they have done in their efforts is, in your opinion, an important part of a case manager’s job…
That’s right. The situation of our clients is often not easy. When a person has so many problems at the same time and has tried to solve some of them themselves in the past, and it hasn’t worked… so in addition to offering solutions and professional services, it is very important to support clients, increase their motivation, and make them aware of what has already been done. In this way, the case manager also tries to offer clients the belief that things can change, even if it has not been possible in the past.
Do you have a specific case of working with a client in the prison system through which you could give a good idea of the case management approach?
One person we work with was in prison due to issues with drug and alcohol use. This client has almost no family background, he has been institutionalized, he lived on the street before serving his sentence, and he is in debt. While serving his sentence, he began working with a colleague case manager. He began to discuss everything with him, and together, they prepared a plan for the client to get out of prison. If this plan had not been created, the client would probably have been one of those who would have stood in front of the prison with just a bag after their release and wondered what to do next, what to eat. Together, they approached a shelter to ensure that the client would have housing secured. On the day of his release, the case manager waited for the client in front of the prison and picked him up, and they went to check in at the shelter. A colleague then accompanied him to the Labor Office, where he helped the client in negotiations with the office’s staff to apply for social benefits in material need. They also discussed his employment and put him in touch with a recruitment agency, which provided him with a quick opportunity to start working. The case manager then handed the client over to the care of our colleagues from the Centre for Counselling Services in prison and after release. They will also work with him in the area of leisure time. The point is that the life of these people does not consist only of time at work and in a shelter. We try to support their life so that it has some other content, that it is worth something, and that it is not just about duties. The client is now meeting with our therapist, and they set out together to get to know the city more. They have visited the library, and now they have agreed to try to go to the climbing wall. Another worker works with him to support sobriety, as the client has decided to abstain from drugs and alcohol. We are also looking for ways to involve the client in debt counselling.
How do you work with the case management method in Podané ruce? In which prisons are you trying to introduce this method to work with prisoners with addiction?
Our organization is implementing a current project supporting the implementation of case management in working with people with addictions in three prisons – Brno Remand Prison, Kuřim Prison and Rapotice Prison. We have a designated contact person in each prison. It is a prison specialist, often a social worker, educator or psychologist. With them, we coordinate our work inside the prison. With each prison, we have negotiated the possibilities of entry and the method of how we can meet with clients. At the beginning, the prison staff would filter out people from the target group of substance users. They work with the SARPO (Comprehensive Risk and Needs Analysis) database, in which prisons keep records of all prisoners and a number of data about them. If an inmate scores a risk level of 6 or higher in this database, they may be offered the opportunity to participate in this project. These people can then meet our case managers for a group discussion. At the end of the discussion, those interested can sign up for an individual initial interview with the case manager. Sometimes, prison staff may directly recommend a selected person interested in support, whom we contact directly. After that, case managers meet with clients in prisons regularly. The frequency of meetings depends on the individual agreement and the possibilities of the prison. Together, they usually prepare a plan for leaving the prison, and on the day of the release, they offer the possibility of being picked up in front of the prison and escorted to the next service or to another place.
How many clients are you working with at the moment?
During the implementation of this project, we have been in contact with at least 40 people in the prison. The program is mostly entered by daily users of addictive substances. They often use intravenously and have a history of attempts at self-abstinence, often unsuccessful. A number of them have also attempted professional treatment. Many of them are in prison repeatedly.
How difficult is it to bring this approach to working with prisoners? What obstacles do you encounter most often?
We have the advantage that we do the case management program in prisons with which we have been cooperating for a long time and in other projects. Cooperation with prisons is therefore at a very good level. The conditions for cooperation are therefore good for us. So, we are dealing more with practical matters, such as the frequency of how often we can, for example, enter prisons in a month to meet directly with clients. We are limited by the spaces in prisons that are suitable for such meetings, where other programs are often held. We have to fit in with the other activities that take place in prisons and that the Prison Service provides. There’s a lot going on in some places. Given the number of clients with whom we work, and the number of people interested in contact, we would otherwise be personally present in prisons even more often.
What would you need most at this moment to further support the work and spread the case management method?
Financial and personnel resources are certainly important. Working with the case management method is quite time-consuming and energy consuming. A large and interrelated complex of problems is being addressed. The case manager often cooperates with a psychologist or psychotherapist and a social worker. But they can’t have dozens of clients at the same time because they wouldn’t be able to provide them with the support they need. It is therefore necessary to be able to pay enough such experts. At the same time, the demands on the position of case managers themselves are quite high in terms of education and personal prerequisites.
How long does it take to prepare an employee for such a position in the organization? It’s not exactly a position for beginner social workers, but rather a position for the more experienced ones…
That’s how I see it. For me, it is also connected with the fact that it is a position where a person enters a prison directly and works with people who have their rights restricted. The demand for workers is associated with the fact that they must be able to work well using this method and, at the same time, they must be able to work in a quality and structured way in the prison. Working in an office consulting service is quite different. There, one can use the Internet, look up information, consult with colleagues, call somewhere. You can bring written materials and other materials to the prison, but you can’t use online support and colleagues as flexibly as you would elsewhere. You don’t have a mobile phone with you, you can’t leave whenever you want, and you have to respect the rules and instructions of the prison on the spot.
So how do you prepare social workers to work in prisons?
We have a sophisticated and comprehensive process of training new employees as well as a well-developed methodology that they can rely on. We also have a long time from the start to the moment when a worker starts entering prisons independently. Until then, they only go there with their colleagues. The more experienced ones accompany their new colleagues. Even if a worker has already taken on the first clients, they still have an older colleague with them who listens, can complement them on the spot, and give them feedback afterwards. Sometimes it takes two months or more for a person to start going to prison on their own. That environment really isn’t for everyone.