A consultation on the joint Department of Health/National Offender Management Service (NOMS) Offender Personality Disorder Pathway Implementation Plan is currently open.The consultation presents three options:
Option 1 – strategic change to re-model services on a pathway model
This will see a phased reduction in the size of the Dangerous Severe Personality Disorder (DSPD) units in high secure hospitals and an increase in the number of treatment places in prisons as well as improved case management services. The Department of Health (DH) is of the view that treatment can be provided at a much lower cost in prison.
Option 2 – no change
This is the most expensive approach per individual and the DH argues that it would deliver fewer completed treatments and poorer outcomes than option 1.
Option 3 – stop all funding for the DSPD programme from the criminal justice system and close NHS funded DSPD units.
This would see the closure of the DSPD units in Whitemoor, Frankland, Low Newton, Broadmoor Hospital and Rampton Hospital. Given the difficulty of dealing with these offenders, alternative approaches would be required to limit the disruption caused by them within the prison estate. If they met the requirements of the Mental Health Act they would be treated in other hospitals, but the number of referrals may increase as a result of the absence of provision in prisons.
While the least expensive option in terms of direct spend, option 3 would increase costs elsewhere within the criminal justice system and provide fewer completed treatments than either of the other scenarios.
This consultation is seeking your views and it closes on 12 May 2011.
Also of interest is A guide to working with offenders with personality disorders published by Ministry of Justice National Offender Management Service and Department of Health on 11 February 2011. It is primarily to support offender managers. However, it is likely to be useful for others, including social workers, psychologists, prison officers, drug and alcohol agency staff and mental health nurses working in community and secure settings.
It provides information about personality disorder and practical advice on how to manage people who can be extremely challenging. It also considers the effect this work can have on staff wellbeing, identifying the signs and consequences, and suggesting how staff can protect themselves.