RESEARCH INTO THE EFFECTIVENESS OF THE LEY COMMUNITY

Any drug and alcohol rehabilitation programme needs to be able to demonstrate how effective it is by providing evidence of its success/failure rate. To this end, the Ley Community appointed Dr Marian Small as Research Psychologist in 1998 to undertake research into the Ley Programme. The methods used in research to demonstrate effectiveness rely on recording events and types of behaviour that can actually be measured. A positive outcome for someone recovering from drug misuse would be a reduction in crime, no further drug use, stable employment and better general health. The way to determine whether any of these changes have really taken place is to make a comparison before and after a person enters treatment. Previous studies carried out at the Ley Community, using this technique, have looked at residents' behaviour after discharge in terms of re-offending (1),(2) and change in drug injection (3). The results clearly indicate that the Ley Programme does reduce both criminal behaviour and frequency of drug use.

These earlier studies also showed that the longer the time spent in treatment the better the outcome. This finding has recently been replicated in an analysis of reconviction rates (4) in respect to all residents admitted to, and subsequently leaving the Ley Community between 1996-97. In this study, 104 ex-residents were followed up and their reconviction rate assessed by comparing the number of offences committed during a 2 year period before admission to a 2 year period after discharge. The interesting factor, dependent on the duration of treatment, becomes clear once the total group of residents is split into four categories depending on the length of time that they remained on the Ley Programme. This is illustrated in the table below:

The results clearly show that the amount of re-offending decreases the longer a resident remains at the Ley. Resident who complete the programme re-commit far less crime (8.5%) than those who leave early. There is also a marked reduction in the crime rate, after discharge, for those who stay longer than 6 months (31%).

During 1998, the Ley Programme was significantly revised and as a consequence the successful completion rate has increased. The Ley Community now sets an ambitious target to achieve successful completions at over 40% of residents leaving during the year. During the last year, between 1 April 2004 and 31 March 2005, a total of 82 residents left the programme of which 28 residents successfully completed. This means that a third of the residents leaving the programme did so on successfully completing it.

The programme is long and demanding, and we know that even those residents who fail to complete benefit from their time at the Ley as described earlier in relation to re-offending rates. The Ley Community sets a target of 35 weeks as the average length of stay of residents during the year. This includes those residents who leave the programme shortly after arriving without giving themselves a chance to settle. During 2004/2005 the average length of stay of the 82 residents leaving the programme was over 38 weeks (approximately nine months). This is a remarkable achievement in relation to retention in view of the challenging nature of the programme.

Constant monitoring of the programme's success rate is obviously very important and, although investigations that compare past and present behaviour are helpful in showing whether changes are maintained over time, studies concerning on-going measurements are also of potential value. A major research study was set up to record how an individual's attitude might alter over time, between admission and discharge, by measuring changes in psychological test scores (such as a reduction in anxiety, improved self-confidence or feeling less angry). Initial results on the first group of residents who have been retested six months after admission for anxiety and depression indicated significant improvements in both variables (5), whilst unpublished results show a significant rise in self-confidence and a reduction in feelings of anger. The research also points to the fact that the residents feel much more in control of their lives. Retesting was also undertaken at one year, eighteen months and two years after admission, and the results indicate positive progress, though the relationship between these factors and long term outcome will have to be determined.