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The Prisoner ACE Survey Understanding the prevalence of adverse childhood experiences (ACEs) in a male offender population in Wales: The Prisoner ACE Survey Kat Ford, Emma R. Barton, Annemarie Newbury, Karen Hughes, Zoe Bezeczky, Janine Roderick, Mark A. Bellis Understanding the prevalence of adverse childhood experiences (ACEs) in a male offender population in Wales: The Prisoner ACE Survey Kat Ford1, Emma R. Barton2, Annemarie Newbury2, Karen Hughes1,2, Zoe Bezeczky2, Janine Roderick2, Mark A. Bellis1,2 1 Public Health Collaborating Unit 2 Policy and International Health Directorate Bangor Institute of Health and Medical Research World Health Organization Collaborating Centre School of Health Sciences on Investment for Health and Well-being Bangor University Public Health Wales NHS Trust Wrexham Technology Park Number 2 Capital Quarter Wrexham LL13 7YP Cardiff CF10 4BZ Tel: +44(0)1248 383519 Tel: +44(0)29 2022 7744 Acknowledgements We would like to express our sincere gratitude towards all the individuals at HMP Parc who participated in this survey. We would like to thank HMP Parc Prison and all their staff for their help with facilitating this research. We would also like to thank Jessica Evans, Hannah Grey, Ellie Worthington, Dr Michelle McManus, Dr Catherine Sharp and Katie Creagh-Barry for their support in study development and report production. Special thanks must go to Kathryn Ashton (Public Health Wales), Dr Benjamin Gray (Public Health Wales), Professor Mike Maguire (Professor in Criminology, University of South Wales) and Mark Crane (Lead Psychologist for HM Prison and Probation Service [HMPPS] in Wales) for providing peer-review of the report. Funding This research was funded through the Early Action Together (EAT) programme1 by the Home Office Police Innovation Fund, South Wales Police and Crime Commissioner (Reference 2016-039) and Public Health Wales. ISBN 978-1-78986-053-5 © 2019 Public Health Wales NHS Trust. Material contained in this document may be reproduced under the terms of the Open Government Licence (OGL) www.nationalarchives.gov.uk/doc/open-government-licence/version/3/ provided it is done so accurately and is not used in a misleading context. © 2019 Bangor University. Material contained in this document may be reproduced provided it is done so accurately and is not used in a misleading context. Acknowledgement to Public Health Wales NHS Trust, Bangor University to be stated. Copyright in the typographical arrangement, design and layout belongs to Public Health Wales NHS Trust, Bangor University. 1 The Early Action Together (EAT) programme is a multi-agency partnership between Public Health Wales, the four Wales Police Forces and Police and Crime Commissioners and Barnardo’s. EAT is working with Criminal Justice partners including Her Majesty’s Prison and Probation Service in Wales and Wales Probation Services to address the root causes of criminal behaviour and enable police and criminal justice staff to take preventative measures when dealing with vulnerable people. Contents 1. Introduction 4 2. Methods 6 3. Findings 7 3.1. Sample demographics 7 3.2. Prevalence of ACEs 8 3.3. Offending history 10 3.4. Relationship between ACEs and crime types 14 3.5. Violence involvement 15 4. Discussion 18 4.1. High prevalence of ACEs 18 4.2. ACEs and participant demographics 19 4.3. Association of ACEs with offending 20 4.4. Association of ACEs with crime types 21 4.5. Violence involvement 21 4.6. Limitations 22 4.7. Conclusion 23 References 25 Appendix 1: Full research methodology 28 Appendix 2: Data tables 34 The Prisoner ACE Survey 1 Adverse childhood experiences (ACEs) in an offender population in Wales The Prisoner ACE Survey interviewed 468 adults (aged 18-69)a in a Welsh prison between February and June 2018. Participants were asked about their exposure to 11 ACEs in childhood, their offending history and recent involvement in violence. How many prisoners reported each ACE? Child maltreatment Household ACEs Verbal abuse Physical Sexual abuse Parental Mental Domestic 50% abuse 18% separation illness violence 41% 58% 28% 40% Emotional neglect Physical neglect Alcohol Drug abuse Incarceration 19% 12% abuse 32% 33% 31% Over 8 in 10 prisoners reported at least 1 ACE, and nearly half had 4 or more ACEsb 0 ACEs 1 ACE 2-3 ACEs ≥4 ACEs 16% 18% 21% 46% Prisoners with 4 or more ACEs were 4 times more likely to have ever served a sentence in a young offender institution (YOI) than those with no ACEs Of the 46% of prisoners who had ever served a sentence in a YOI: 9 in 10 6 in 10 had at least 1 ACE compared to 8 in 10 of had 4 or more ACEs compared to 3 in 10 of those who did not spend time in a YOI those who did not spend time in a YOI 2 The Prisoner ACE Survey Adverse childhood experiences (ACEs) Compared with prisoners with no ACEs, those with 4 or more ACEs were: in an offender population in Wales 3x more likely to have ever been convicted of criminal damage 3x more likely to have ever been convicted of violence against the person 3x more likely to have ever been convicted of theft 2x more likely to have ever been convicted of drugs offences Those with 4 or more ACEs were also 3.5 times more likely to be prolific offendersc Of the 39% of prisoners categorised as prolific offenders: 9 in 10 6 in 10 had at least 1 ACE compared to 8 in 10 of had 4 or more ACEs compared to 4 in 10 of those not categorised as prolific offenders those not categorised as prolific offenders The proportion of individuals ACEs substantially increased the risks reporting 4 or more ACEs increased of recentd violence involvement with number of times in prison 0 ACEs 1 ACE 2-3 ACEs ≥4 ACEs % reporting recent violence involvement 0 ACEs ≥4 ACEs 25% 59% 21% 49% 47% 29% 20% 23% 22% 8% 25% 13% First time in prison ≥7 times in prison Violence perpetration Violence victimisation a Seven in 10 participants were Welsh, 25% were aged 18-24, 84% were white and almost a third reported that they had no educational qualifications, see main report. b ACE counts do not add up to 100% due to rounding. In comparison, ACE prevalence figures for males in the general population were 54% 0 ACEs, 19% 1 ACE, 16% 2-3 ACEs, 12% ≥4 ACEs, see main report. c Based on how many convictions they reported, classified using the Ministry of Justice prolific offending definition, see main report. d In the past 12 months. The Prisoner ACE Survey 3 1. Introduction The experiences that children have while growing up can have life-long effects on their health and well-being. A growing body of research in Wales and internationally is showing how adverse childhood experiences (ACEs; see Box 1) can negatively impact individuals’ life opportunities, and increase the risk of involvement in crime [1]. The Welsh ACE studies found that half of adults Until recently, research in justice-involved in the general population in Wales suffered at populations had tended to focus on just one least one ACE in childhood, and over one in 10 (e.g. physical abuse) or a few types of trauma suffered four or more [1,2]. Individuals who had [13,14]. However, studies are now starting to suffered four or more ACEs were 20 times more emerge that use the ACE framework to measure likely to have been incarcerated at some point in multiple types of childhood adversity and their lives [1]. Correspondingly, studies have found their cumulative impact on offending behaviour that individuals in the criminal justice system [15-18]. For example, in a sample of incarcerated report higher levels of childhood adversity than male adults in the USA, over 90% reported at least those in the general population [3-5], and that one ACE and 50% reported four or more ACEs ACEs are associated with more serious offending [19]. In Scotland, ACE questions were incorporated and recidivism. However, very few studies have into the 2017 Scottish Prisoner Survey; this explored the prevalence of ACEs in UK prison identified high prevalence of individual ACEs populations or associations between ACEs and but did not report ACE count levels [20]. crime. To develop this knowledge in Wales, the Among youth, ACEs have been associated with Prisoner ACE Survey surveyed a prison population an increased risk of serious offending, and to understand how many ACEs they had reoffending [16,21,22]. For example, a US study experienced and the associations between ACEs of juvenile offenders found that while 80% had and offending histories (e.g. type of crime). at least one ACE and 23% had four or more ACEs, ACE counts were, on average, twice as high among youths that were serious, violent or chronic Box 1: Adverse childhood offenders [23]. In the UK, a study following a experiences (ACEs) cohort of high-risk boys from London found that ACEs are traumatic or stressful experiences the mean number of lifetime convictions (from occurring before the age of 18 years, such as age 10 to 56 years) tended to increase as ACE suffering physical, emotional or sexual abuse, count increased [16]. or living in a household affected by domestic violence or drug misuse. Individuals who have ACEs can be intergenerational, with children experienced ACEs are at an increased risk of that suffer ACEs at increased risk of developing poor health across the life course, including behaviours and conditions which can later become mental illness [2,6], the early development of ACEs for their own children [24]. In 2009 in chronic health conditions (e.g. asthma, type England and Wales, an estimated 200,000 children 2 diabetes [1,7]), and premature mortality had at least one parent incarcerated [25].
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