Evaluating effectiveness of open prison services within the OPD pathway: What drives success and failure in open prison services for high risk offende

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Personality disorder is a complex mental health conditionthat can involve severe deficiencies in relationship skills,identify dysfunction and, in extreme cases, a risk of physicalharm to others (1). Personality disorder is a prevalentdiagnosis in the UK (2). Estimates suggest between 4.4 and13 percent of the general population could meet the criteriafor any personality disorder diagnosis (3). Within the criminaljustice system (CJS), personality disorder is overrepresentedwith estimates suggesting 65% of male prisoners meetingthe criteria (4). Due to the prevalence, personality disorder isa prominent issue with the CJS. Stemming from thechallenging and complex nature of personality disorder,professionals are often unwilling to work with or experienceburnout through working with the population (5,6,7).However, treatment and intervention with this population ispossible but research in the area is generallymethodologically poor (8,9).The Offender Personality Disorder Pathway (OPD Pathway)The Offender Personality Disorder Pathway (OPD Pathway) isa joint initiative between the UK Ministry of Justice and NHSEngland to provide psychologically informed services acrossthe CJS for high risk offenders who are likely to have adiagnosis of 'personality disorder' (10). The pathway is basedon a whole systems approach, recognising the variousstages of an offender's journey from sentence throughprison and/or NHS detention to community-based7 / 11supervision and re-settlement. The aims of the OPD Pathwayare to reduce re-offending, improve offender psychologicalhealth and wellbeing as well as improve the confidence, skillsand attitudes of staff working with personality disorderedoffenders (10).The OPD pathway has a national coverage across probationand adopts a formulation-based approach, as well asspecialist psychologically informed, intervention servicesfrom Category A prisons through to the community forexample, democratic therapeutic communities andPsychologically Informed Prison Environments (PIPEs) acrosscustody and community Approved Premises. The previousDangerous and Severe Personality Disorder (DSPD)government strategy was not cost-effective and so thefunding was redistributed to form the current OPD Pathway,aiming to cover more of the needs of personality disorderedoffenders (11).There is currently only one OPD Pathway open prison (male),at HMP Standford Hill. The service, known as PathwaysEnhanced Resettlement Service (PERS), has a focus on highrisk offenders who have a high likelihood of 'failing' in theshort-term, either reoffending or being returned to a secureprison environment. The aim of the PERS service is to shiftpsychological to practical hazards, modelling communitysettings as much as possible. Service users can spend up totwo years in service with the aim of release into thecommunity. The OPD Pathway has been successful inobtaining funding for an additional three open prison sites, inaccordance with the PERS model (two of which will take onsex offenders) over a period of three years.The Research QuestionFor my PhD research, I will undertake a mixed-methodevaluation, including advanced quantitative modelling,across all four OPD pathway open prison services. Theresearch will aim to answer the overarching question; areopen prison (male) OPD services effective? There are fourspecific research questions:1) How do prisoners accepted into specialist open prisonservices (SOPS) differ from a comparison group of offenderstransferred to standard open prisons?2) What factors differentiate those who successfully progressfrom SOPS from those who are returned to closed conditionsand/or reoffend?3) What narratives do offenders use to account for:a. Successful progression from SOPS?b. Failure to progress?4) How can we causally model the key drivers for outcomesfrom SOPS