1. National Evaluation of Offender Personality Disorder Pathway Manuela Jarrett & Paul Moran on behalf of the team

2. National Evaluation Offender Personality Disorder Pathway

3. PD RESEARCH: Paul Moran HSR: Tim Weaver, Julie Trebilcock, Mike Crawford ECONOMICS: Barbara Barrett STATISTICS: Mizan Khondoker CJS HSR: Jenny Shaw, Manuela Jarrett Andrew Forrester PATHWAY EXPERTISE: Caroline Logan, Julian Walker, Colin Campbell PPI: Louise Morgan The NEON Team

5. Overview  Offender PD Strategy  Transforming Rehabilitation  National Evaluation of OPD Pathway  Stage 1: Feasibility

6. The OPD Strategy  Dangerous and Severe PD Programme (1999)  Decommissioned  The Offender PD Strategy (2011)  Joint NHS England and NOMS  Joint working probation and psychology  Money from DSPD Programme  Broaden out risk criteria

7. 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

8. 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.

9. 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

10. Case formulation as intervention  Intervention may be case formulation  Psychologically informed approach  Intervention involves shift in approach towards offender  What drives behaviour, link to earlier life events, triggers  Offender Managers are ‘service users’

11. Transforming Rehabilitation  Radical restructuring of probation services (2014-15)  Single national service  National Probation Service – High Risk  Community Rehabilitation Companies – Low and Medium Risk  Introduction of new IT system for case management

12. National Evaluation of OPD Pathway  Men only, age 18 ≥ years  Prisons, Approved Premises, NHS  Approximately 16,000 offenders in Pathway  Only NPS Offenders  Two Stages – Stage 1: Feasibility of Methods (18 months) – Stage 2: Definitive Evaluation (3.5 years)

13. Process EconomicImpact

14. Process To provide an understanding of how the Pathway operates Impact To assess effectiveness of the Pathway on reducing reoffending and improving psychological health Economic To provide evidence on the cost-effectiveness of the Pathway, using economic decision modelling NEON: Over-arching objectives

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

17. Testing feasibility Expert Reference Groups Survey Individual Interviews Access to CJS data Measure: Psychological Wellbeing and Functioning

18. 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

19. 1.Define the ‘pathway’ 2.Sample a group of services 3.Feasible to access and extract routinely collected data 4.Feasible to link data 5.Feasible for probation to use 2 short additional measures – Psychological Wellbeing and Functioning 6.Collect follow-up and pre-Pathway data on a selected sample of offenders Stage 1 - Feasibility

20. Thank you For further information: manuela.jarrett@kcl.ac.uk