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11 March, 2015
Sarah SkettJoint Lead, OPD Programme, NHS [email protected]
Ian GoodeJoint Lead, OPD Programme, [email protected]
Evening Seminar
Offender Personality Disorder
Pathway Programme
Strategic Context
Inclusion for DSPD:
Evaluating Assessment
and treatment
(IDEA)
(March 2006 – August
2009)
Tom Burns, Jenny Yiend, Tom Fahy,
Seena Fazel, Ray Fitzpatrick,
Julia Sinclair, Robert Rogers, Maria
Vasquez Montes
Multi-method Evaluation of
the Management,
Organisation and Staffing
(MEMOS) in high security
treatment services for
people with Dangerous and
Severe Personality Disorder
(DSPD)
(October 2010)
Tim Weaver, Julie Trebilcock, Mary Leamy,
Mohammed Al-Hairi, Mike Crawford
& Peter Tyrer
DSPD Strategy economic and financial modelling October
2010.
TRIBAL consulting
Strategic Context
Strategic context
Response to the offender
personality disorder consultation Oct
2011,, page 11:
“The Government believes
that the £69m currently
invested in DSPD services
can be used more effectively
to improve the management of
offenders thereby reducing re-
offending, risk of harm to the
public, and providing more
treatment places and high
quality services.”
What is Personality Disorder?
Persistent
PervasiveProblematic
Equality
BME
• Effect of Culture
• Over representation in CJS
• Under representation in services
• Responsivity
Disability
• Physical access to services
• Cognitive capacity
• Responsivity
Gender
• Evidence of differences and similarities
• Responsivity
The entry criteria for services
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
• Likely to have a severe personality disorder
• A clinically justifiable link between the personality disorder and the risk
• Managed by NPS
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
• Likely to have a severe form of personality disorder
• A clinically justifiable link between the above
Estimate of need and demand- men / custody
No. of males in custody June 2012
Offenders who pass harm
screen (and included in
analysis)
Offenders who pass harm screen
and satisfy at least one of the
five other screening criteria
no. % no. %
Sentence Length <12 months determinate
5,924 1,13719%
678 11%
12+ months determinate
42,414 7,33917%
4,057 10%
IPP 5,813 1,837 32% 1,199 21%
Life 7,204 1,072 15% 728 10%
Recall 5,071 1,809 36% 1,345 27%
Total 66,426 13,194 20% 8,007 12%
Estimate of need and demand – men / community
No. of males in the
community June 2012
Offenders who pass harm
screen (and included in
analysis)
Offenders who pass harm screen and
satisfy at least one of the five
other screening criteria
no. % no. %
Sentence Type Licence 44,551 5,052 11% 2,678 6%
CO / SSO 72,622 8,307 11% 4,871 7%
Punitive only orders 24,667 627 3% 246 1%
Total 141,840 13,986 10% 7,795 5%
No. of females in
custody June 2012
Offenders who pass harm
screen (and included in
analysis)
Offenders who pass harm screen and
satisfy at least one of the five other screening
criteria
no. % no. %
Sentence Length <12 months determinate
622 15325%
7448%
12+ months determinate
1,989 65533%
30146%
IPP 125 98 78% 78 80%
Life 252 249 99% 137 55%
Recall 206 88 43% 65 74%
Total 3,194 1,243 39% 655 53%
Estimate of need and demand – women / custody
No. of females in
the community June 2012
Offenders who pass harm
screen (and included in
analysis)
Offenders who pass harm screen and
satisfy at least one of the five
other screening criteria
no. % no. %
Sentence Type Licence 3,037 943 31% 436 14%
CO / SSO 13,698 5,113 37% 2,276 17%
Punitive only orders
3,263 73923%
371%
Total 19,998 6,795 34% 2,749 14%
Estimate of need and demand – women / community
Need – 20,000 men and women offenders
Demand - ?
Estimate of need and demand – conclusions
Underpinning principles
Shared responsibility
Joint operations
Community-to-community
pathway
Staff have clarity of approach,
primary task & role;
Are well trained, supported & supervised;
Account is given to staff perceptions
Service users have clarity of
approach, role & responsibility
Account is given to service
user perceptions
Case formulation
Psychologically informed
Long-term pathway commitment
Managing breakdown& failure
Workforce development
Use resources efficiently
Pu
blic p
rotectio
nPs
ych
olo
gica
l hea
lth
im
pro
vem
en
t
Enabling Environments
Case identificationPathway planning
Community case management
PIPEs
PIPEs
OP
D t
reat
men
tO
ffend
ing
beh
aviou
r p
rogram
me
s
Risk management
Key MilestonesTo Jointly Commission with NOMS and the NHS
• New community based PD services in all probation areas
• Up to 6 new PD treatment services for men in prisons - (total of 300 places)
• Up to 13 new PD progression services in prisons and in approved premises (800 places)
• PD treatment services for women in prison - up to four services (total of 80 places)
• PD workforce development in prisons and probation
• Appropriate information technology
• A number of support services linked to the programme, such as: a) field test in a prison working with violent and disruptive prisoners, b) PD support for Close Supervision Centres c) Therapeutic Communities for prisoners with LD
d) PD treatment services in the community
• PD programme evaluation
The services
North
London
Midlands & EastWales
South
MSU Oswin,
Newcastle
Community outreach.Treatment
HMP Frankland, Durham.
PD TrtPIPE
HMP Full Sutton, York.CSC support
HMP Garth,
Preston.PD Trt
Resettle, Liverpool.
PD Trt
Community ID, case formulation, pathway planning and case management
HMP HullPIPE
HMP Wymott, Preston.
PIPE
HolbeckHouse AP,
Leeds.PIPE
Bradshaw House, AP,
Manchester.PIPE
The Retreat, York.
PD Trt
Stafford House, AP Liverpool.
PIPE
AshworthPD Trt
NORTH
LeedsMBT Pilot site
LiverpoolMBT Pilot site
LancashireMBT Pilot site
Southview AP, York.PIPE
Community outreach.Treatment
Rampton, RetfordPD Trt
TC+
HMP Whitemoor,
MarchPD Trt
HMP Dovegate, Utoxeter
DTCTC +
HMP Warren
Hill, Ipswich.
DTCPIPE
Community ID, case formulation, pathway planning and case management
HMP Wayland, Thetford.
PD TrtPIPEKirk Lodge AP,
Leicester.PIPE
HMP Gartree, Market
Harborough DTCTC+PIPE
MIDLANDS
HMP SwinfenHall, Lichfield,
PD TrtPIPE
LincolnshireMBT Pilot site
Staffs and WMMBT Pilot site
NottsMBT Pilot site
HMP Long Lartin, Evesham
Prep PIPE
HMP Woodhill,
Milton KeynesCSC support
MSUJohn
Howard Centre
Community outreach.Treatment
HMP BelmarshPD Trt
Pathway planning
Community ID, case formulation, pathway planning and case management ALL AP will be Enabling Environments
Community outreach
PD Trt
LONDON
MSURiver House
HMP Pentonville,
ESS
Community Outreach Housing projects
London NWMBT Pilot site
London NEMBT Pilot site
London SEMBT Pilot site
London SWMBT Pilot site
Community outreach
PD Trt
Community outreach.Treatment
HMP Grendon,Aylesbury
DTCTC +
Pathfinder Bristol
Pathway planning,
PD Trt
Community ID, case formulation, pathway planning and case management
HMP Swaleside, Sheppey
PD TrtPre PIPE
PIPEESS
HMPYOI Ayelsbury,
PD Trt
Pathfinder, South,
Pathway planning,
PD Trt
Broadmoor,PD Trt
SOUTH and WALES
WalesMBT Pilot site
DevonMBT Pilot site
GloucestershireMBT Pilot site
HMP Send, nr GuildfordPrep PIPE
DTCPIPEEE
HMP Holloway,
London, DBT Service
HMP FostonHall,
Derby,PD TrtCARE
EE
HMP Drake Hall,Stafford,
whole prison EE
HMP Eastwood
Park, Bristol,Prep PIPE
PD TrtEE
HMP Styal, Cheshire
EE
HMP New Hall,
Wakefield,PD TrtCARE
EE
Rampton,PD Trt
WOMEN’S PATHWAY
Community ID, case formulation, pathway planning and case management
MSUArnold Lodge
LeicesterWEMS
MSUThe Orchard
SouthallWEMS
MSUEdenfield
ManchesterWEMS
HMP Peterborough,
EE
Mentoring & advocacy
service for N. England & N.
Wales
Mentoring &
advocacy support in
London
Mentoring & advocacy support in
Birmingham
Edith Rigby AP, Preston
PIPE
Crowley House AP,
BirminghamPIPE
HMP Bronzefield,
StainesEE
HMP Low Newton, DurhamPD TrtPIPEEE
Intensive Integrated
Risk Management Service, Yorks
& Humber
HMP Frankland, Durham.
PD TrtPIPE
HMP Full Sutton, York.
CSC support
HMP Garth,
Preston.PD Trt
AshworthPD Trt
NATIONAL – HIGH SECURE
Broadmoor,PD Trt
HMP Belmarsh,
LondonPD Trt
MSUJohn Howard
Centre
MSU,River House
HMP Grendon,Aylesbury,
DTCTC+
HMP Swaleside,Sheppey,
PIPE
PD Trt
HMP Whitemoor,
MarchPD Trt
Rampton,PD Trt,
TC+
HMP Gartree,Market
Harborough,DTCTC+PIPE
HMP Dovegate,Utoxeter,
DTCTC+
Arnold Lodge, MSU
MSU,Oswin
HMP Hull,PIPE
SO only
HMP Woodhill,
Milton KeynesCSC support
HMP Long Lartin,
EveshamPrep PIPE
What are the gaps?
Gaps
Sex Offenders pathway
Community CJS Treatment
High secure
post pipe
Cat C pre pipe
Community Forensic
mental health services
Pathway out of
custody –Cat D
LD pathway
Supported housing
More PIPES in
APs
1. To evaluate the effectiveness of the Pathway
• How was the PD strategy delivered?
• What difference did the PD strategy make?
• Did the benefits justify the costs?
In addition:
2. To evaluate the effectiveness of individual
programmes, including pilots/field tests;
3. To evaluate the development of new tools (e.g. case
formulation, training materials);
4. To develop knowledge in the field of forensic PD
Research and Evaluation
National Evaluation
OPD Treatment
IONNA
A case study investigation into the Chromis programme
PIPE
Impact Staff Training Module (KUF)
Evaluation of the women’s PDPathway in Lancashire
DTC
An evaluation of risk reduction Following treatment using
HCR20
Pathway Effectiveness
ServiceImpact
Practice and Development
Research Programme (three levels)
National Evaluation (male offenders)
• Kings College London (KCL) lead
• Starts 1st August 2014 for 4 years
• Stage 1 (first 18 months) feasibility: develop
Pathway theory, test data collection, analysis
• Stage 1 focus on OPD Pathway in North of England
“The key principle for the national OPD Programme is that
outcomes will be achieved and maintained by the offender
accessing a Pathway of services, rather than accessing a
single intervention or programme.”
National Evaluation
Process study – How was the PD strategy delivered?
• Aim - to provide a robust theoretical understanding of how the pathway
operates, how the Pathway has been delivered and explain the outcomes of
the impact and economic evaluations in light of these expectations.
Impact study – What difference did the PD strategy make?
• Aim - to assess the effectiveness of the Offender Personality Disorder
Pathway on reducing reoffending and improving psychological health; and
guide commissioners, providers and policy makers on which aspects of the
programme are most effective and how the programme can be refined.
Economic evaluation – Did the benefits justify the costs?
• Aim to provide evidence on the cost effectiveness of the Pathway, to
support NHS England and NOMS in its on-going strategic planning of the
pathway
Offender PD Pathway Co-Commissioning Team Structure
Ian Goode
NOMS and Joint
Head of OPD
Team
Laura d’CruzNOMS Senior
Co-Commissioning
Manager
London and
national women’s
lead
Kirk TurnerNOMS Senior
Co-Commissioning
Manager
Therapeutic
Environments
Nick JosephNOMS Senior
Co-Commissioning
Manager
South (incl. Wales)
Sarah BridglandNOMS
OPD
Research
Manager
Patrick Wall
(covering for Debra
Jeffrey – on
Maternity leave)
Workforce
Development
& OPD
Engagement
Manager
Neil PigginNOMS Regional
Co-Commissioning
Manager
(North)
Rachel WilsonNOMS Regional
Co-Commissioning
Manager
(Midlands
and East)
Kathryn Harney
Greater Manchester
West MH NHS FT
PD Research
Advisor
Sarah Skett
NHS and
Joint Head
of OPD Team
ZoeThornton
NHS Specialised
Commissioning
South (Wessex)
Jennie Slater
Therapeutic
Communities
Development
Manager
Joint SROs
Simon Boddis
(NOMS)
tbc
(NHS England
Guy Cross
DH
Personality
Disorder policy
contact
As at 2-3-2015
Mick Burns
NHS Specialised
Commissioning North
(South Yorkshire
and Bassetlaw)
Terry Kirkby
NHS Specialised
Commissioning
Midlands and East
(Leicestershire
and Lincolnshire)
+ Wales
Mary O’Donnell
NHS Specialised
Commissioning
London
Jeremy Glyde
Programme
Director
Specialised
Services
Questions ?