National Evaluation of Offender Personality

Disorder Pathway

Manuela Jarrett & Paul Moran on behalf of

the team

National Evaluation Offender Personality Disorder Pathway

PD RESEARCH: Paul MoranHSR: Tim Weaver, Julie Trebilcock, Mike CrawfordECONOMICS: Barbara BarrettSTATISTICS: Mizan KhondokerCJS HSR: Jenny Shaw, Manuela JarrettAndrew ForresterPATHWAY EXPERTISE: Caroline Logan, Julian Walker,Colin Campbell PPI: Louise Morgan

The NEON Team

Overview

Offender PD StrategyTransforming RehabilitationNational Evaluation of OPD PathwayStage 1: Feasibility

The OPD Strategy

Dangerous and Severe PD Programme (1999) Decommissioned

The Offender PD Strategy (2011)Joint NHS England and NOMSJoint working probation and psychologyMoney from DSPD Programme Broaden out risk criteria

Criteria

Men

• Assessed as presenting a high likelihood of violent or sexual offence repetition and high or very high risk of serious harm to others at some point during their current sentence

- ‘high risk-high harm’

Women

• Current offence of violence against the person, criminal damage, sexual and/or against children

• Assessed as presenting a high risk of committing an offence from the above categories

plus• Likely to have a severe form of personality disorder

• A clinically justifiable link between the personality disorder and the risk

Early Identification (Men) Screened in by Offender Manager on OASyS PD screening tool:

•Life Sentence•Imprisonment for Public Protection –offenders previous to 2012 •Determinate sentence for violent or sexual offence

or ≥2 •Childhood abuse, difficulties or behaviour problems•History of mental health problems•History of self harm/attempted suicide•Attacks on staff

≥7 of following 11 items:•Convictions aged under 18 years•Diversity of offending categories• Violence/threat of violence/coercion•Excessive use of violence/sadistic violence•Recognises victim impact•Financial over reliance on friends, family, others for support•Predatory lifestyle•Reckless/risk taking•Childhood behaviour problems•Impulsivity•Aggressive/controlling behaviour.

Pathway Services

Case Identification Screening Case consultation

Case formulation Pathway plan

PIPE (pre treatment) PD treatment intervention Offender behaviour programme PIPE (post treatment) Community case management

Overseen by Offender Managers

Case formulation as intervention

Intervention may be case formulationPsychologically informed approachIntervention involves shift in approach

towards offenderWhat drives behaviour, link to earlier life

events, triggersOffender Managers are ‘service users’

Transforming Rehabilitation

Radical restructuring of probation services (2014-15)

Single national serviceNational Probation Service – High RiskCommunity Rehabilitation Companies – Low and

Medium Risk

Introduction of new IT system for case management

National Evaluation of OPD Pathway

Men only, age 18 ≥ yearsPrisons, Approved Premises, NHSApproximately 16,000 offenders in PathwayOnly NPS OffendersTwo Stages

– Stage 1: Feasibility of Methods (18 months)– Stage 2: Definitive Evaluation (3.5 years)

Process

EconomicImpactRealistic

Evaluation

ProcessTo provide an understanding of how the Pathway operates

ImpactTo assess effectiveness of the Pathway on reducing reoffendingand improving psychological health

EconomicTo provide evidence on the cost-effectiveness of the Pathway,using economic decision modelling

NEON: Over-arching objectives

Diversity of service provision Complexity of interventions Pathway is still evolving Geographical spread Time constraints Existing evaluations Language: ‘PD’ ‘Pathway’

Key Challenges

Testing feasibilityExpert Reference Groups Survey Individual Interviews

Access to CJS data Measure: Psychological Wellbeing and Functioning

Outcome Domains

RISK – OASys (wtd score + band); OGRS

RE-OFFENDING – episodes of re-offending

INSTITUTIONAL MISCONDUCT - adjudications

COMPLIANCE ON RELEASE – breaches, recall to prison,

PSYCHOLOGICAL WELL-BEING AND SOCIAL FUNCTION

SELF-HARM – ACCT

ACCESS AND PROGRESSION THROUGH PATHWAY

1. Define the ‘pathway’2. Sample a group of services3. Feasible to access and extract routinely collected data4. Feasible to link data5. Feasible for probation to use 2 short additional

measures – Psychological Wellbeing and Functioning6. Collect follow-up and pre-Pathway data on a selected

sample of offenders

Stage 1 - Feasibility

Thank you

For further information:manuela.jarrett@kcl.ac.uk