Offender Personality Disorder Pathway Programme

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1 Evening Seminar Offender Personality Disorder Pathway Programme 11 March, 2015 Sarah Skett Joint Lead, OPD Programme, NHS England Ian Goode Joint Lead, OPD Programme, NOMS

2 Strategic Context

3 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 TRIBAL consulting

4 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 reoffending, risk of harm to the public, and providing more treatment places and high quality services.

5 Persistent What is Personality Disorder? Problematic Pervasive

6 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

7 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

8 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 Sentence Length no. % no. % <12 months 5,924 1,137 determinate 19% % 12+ months 42,414 7,339 determinate 17% 4,057 10% IPP 5,813 1,837 32% 1,199 21% Life 7,204 1,072 15% % Recall 5,071 1,809 36% 1,345 27% Total 66,426 13,194 20% 8,007 12%

9 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, % 246 1% Total 141,840 13,986 10% 7,795 5%

10 Estimate of need and demand women / custody 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 Sentence Length no. % no. % <12 months 25% 48% determinate 12+ months 33% 46% 1, determinate IPP % 78 80% Life % % Recall % 65 74% Total 3,194 1,243 39% %

11 Estimate of need and demand women / community 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, % % CO / SSO 13,698 5,113 37% 2,276 17% Punitive only 23% 1% 3, orders Total 19,998 6,795 34% 2,749 14%

12 Estimate of need and demand conclusions Need 20,000 men and women offenders Demand -?

13 Underpinning principles Shared responsibility Joint operations Service users have clarity of approach, role & responsibility Account is given to service user perceptions Community-tocommunity pathway Case formulation Psychologically informed Staff have clarity of approach, primary task & role; Are well trained, supported & supervised; Account is given to staff perceptions Long-term pathway commitment Managing breakdown& failure

14 Psychological health improvement OPD treatment Workforce development Case identification Pathway planning Risk management Enabling Environments s s Offending behaviour programmes Public protection Community case management Use resources efficiently

15 Key Milestones To 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

16 The services North Wales Midlands & East South London

17 NORTH Community outreach. Treatment MSU Oswin, Newcastle Frankland, Durham. Lancashire MBT Pilot site Garth, Preston. Wymott, Preston. Southview AP, York. The Retreat, York. Full Sutton, York. CSC support Liverpool MBT Pilot site Holbeck House AP, Leeds. Leeds MBT Pilot site Hull Ashworth Resettle, Liverpool. Stafford House, AP Liverpool. Bradshaw House, AP, Manchester. Community ID, case formulation, pathway planning and case management

18 MIDLANDS Notts MBT Pilot site Rampton, Retford TC+ Staffs and WM MBT Pilot site Swinfen Hall, Lichfield, Dovegate, Utoxeter DTC TC + Kirk Lodge AP, Leicester. Lincolnshire MBT Pilot site Whitemoor, March Wayland, Thetford. Long Lartin, Evesham Prep Woodhill, Milton Keynes CSC support Gartree, Market Harborough DTC TC+ Community outreach. Treatment Warren Hill, Ipswich. DTC Community ID, case formulation, pathway planning and case management

19 LONDON Community outreach. Treatment London NW MBT Pilot site Community outreach London NE MBT Pilot site Pentonville, ESS MSU John Howard Centre London SW MBT Pilot site Community Outreach Housing projects Community outreach MSU River House Belmarsh Pathway planning London SE MBT Pilot site Community ID, case formulation, pathway planning and case management ALL AP will be Enabling Environments

20 SOUTH and WALES Grendon, Aylesbury DTC TC + YOI Ayelsbury, Broadmoor, Wales MBT Pilot site Devon MBT Pilot site Pathfinder Bristol Pathway planning, Gloucestershire MBT Pilot site Pathfinder, South, Pathway planning, Community outreach. Treatment Swaleside, Sheppey Pre ESS Community ID, case formulation, pathway planning and case management

21 MSU Edenfield Manchester WEMS Eastwood Park, Bristol, Prep EE WOMEN S PATHWAY Styal, Cheshire EE Drake Hall, Stafford, whole prison EE Crowley House AP, Birmingham Edith Rigby AP, Preston Foston Hall, Derby, CARE EE Mentoring & advocacy support in Birmingham Intensive Integrated Risk Management Service, Yorks & Humber MSU Arnold Lodge Leicester WEMS New Hall, Wakefield, CARE EE Bronzefield, Staines EE Send, nr Guildford Prep DTC EE Rampton, Mentoring & advocacy service for N. England & N. Wales Peterborough, EE Holloway, London, DBT Service MSU The Orchard Southall WEMS Community ID, case formulation, pathway planning and case management Low Newton, Durham EE Mentoring & advocacy support in London

22 Ashworth NATIONAL HIGH SECURE Long Lartin, Evesham Prep Garth, Preston. Dovegate, Utoxeter, DTC TC+ Woodhill, Milton Keynes CSC support Arnold Lodge, MSU Gartree, Market Harborough, DTC TC+ Grendon, Aylesbury, DTC TC+ MSU, Oswin Rampton,, TC+ Broadmoor, Frankland, Durham. MSU John Howard Centre Full Sutton, York. CSC support Belmarsh, London Hull, SO only Whitemoor, March MSU, River House Swaleside, Sheppey,

23 What are the gaps?

24 Gaps High secure post pipe Sex Offenders pathway Community CJS Treatment Community Forensic mental health services Cat C pre pipe Pathway out of custody Cat D More S in APs LD pathway Supported housing

25 Research and Evaluation 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

26 Research Programme (three levels) Pathway Effectiveness National Evaluation Service Impact OPD Treatment DTC Practice and Development IONNA An evaluation of risk reduction Following treatment using HCR20 Impact Staff Training Module (KUF) A case study investigation into the Chromis programme Evaluation of the women s PD Pathway in Lancashire

27 National Evaluation (male offenders) 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. Kings College London (KCL) lead Starts 1 st 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

28 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

29 Offender PD Pathway Co-Commissioning Team Structure Joint SROs Simon Boddis (NOMS) tbc (NHS England Jeremy Glyde Programme Director Specialised Services Ian Goode NOMS and Joint Head of OPD Team Sarah Skett NHS and Joint Head of OPD Team Laura d Cruz NOMS Senior Co-Commissioning Manager London and national women s lead Patrick Wall (covering for Debra Jeffrey on Maternity leave) Workforce Development & OPD Engagement Manager Kirk Turner NOMS Senior Co-Commissioning Manager Therapeutic Environments Sarah Bridgland NOMS OPD Research Manager Jennie Slater Therapeutic Communities Development Manager Nick Joseph NOMS Senior Co-Commissioning Manager South (incl. Wales) Neil Piggin NOMS Regional Co-Commissioning Manager (North) Rachel Wilson NOMS Regional Co-Commissioning Manager (Midlands and East) Guy Cross DH Personality Disorder policy contact Kathryn Harney Greater Manchester West MH NHS FT PD Research Advisor Mick Burns NHS Specialised Commissioning North (South Yorkshire and Bassetlaw) ZoeThornton NHS Specialised Commissioning South (Wessex) Terry Kirkby NHS Specialised Commissioning Midlands and East (Leicestershire and Lincolnshire) + Wales Mary O Donnell NHS Specialised Commissioning London As at

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