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