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

人格障碍是一种复杂的精神健康状况，可能涉及人际关系技巧的严重缺陷，识别功能障碍，在极端情况下，可能会对他人造成身体伤害(1)。在英国，人格障碍是一种普遍的诊断(2)。据估计，一般人群中有4.4%到13%的人符合任何人格障碍的诊断标准(3)。在刑事司法系统（CJS）中，人格障碍的比例过高，估计有65%的男性囚犯符合这一标准(4)。由于其普遍性，人格障碍是CJS的突出问题。由于人格障碍的挑战性和复杂性，专业人员通常不愿意与人群一起工作或通过与人群一起工作而经历倦怠（5,6,7）。然而，对这一人群进行治疗和干预是可能的，但该领域的研究在方法学上通常很差（8,9）。罪犯人格障碍途径（OPD途径）罪犯人格障碍途径（OPD途径）是英国司法部和nhs英格兰之间的联合倡议，旨在为可能被诊断为“人格障碍”的高危罪犯提供跨CJS的心理信息服务（10）。该途径基于一个完整的系统方法，认识到罪犯从判刑到监狱和/或NHS拘留到基于社区的监督和重新安置的各个阶段。OPD途径的目标是减少再犯罪，改善罪犯的心理健康和福祉，以及提高与人格障碍罪犯打交道的工作人员的信心、技能和态度（10）。OPD途径在全国范围内覆盖整个试用期，并采用基于公式的方法，以及从a类监狱到社区（例如，民主治疗社区和心理知情监狱环境）的专业心理知情干预服务。先前的危险和严重人格障碍（DSPD）政府战略不具有成本效益，因此资金被重新分配，形成了目前的OPD途径，旨在满足更多人格障碍罪犯的需求（11）。目前只有一所OPD Pathway开放式监狱（男性），位于斯坦福山HMP。这项服务被称为路径强化安置服务（PERS），重点关注那些短期内很可能“失败”的高风险罪犯，他们要么再次犯罪，要么被送回安全的监狱环境。PERS服务的目的是将心理危害转化为实际危害，尽可能模拟社区环境。服务用户可以在服务中花费长达两年的时间，目的是将其发布到社区。OPD途径已经成功地获得了额外三个开放监狱的资金，按照PERS模式（其中两个将接受性犯罪者），为期三年。在我的博士研究中，我将采用混合方法，包括先进的定量建模，对所有四个OPD途径开放的监狱服务进行评估。研究将旨在回答首要问题；开放式监狱（男性）OPD服务有效吗？有四个具体的研究问题：1)接受进入专业开放式监狱服务（SOPS）的囚犯与被转移到标准开放式监狱的比较组罪犯有何不同？2)哪些因素能区分那些从sop成功进步的人与那些回到封闭环境和/或再犯的人？3)罪犯用什么叙述来解释？从sop成功升级？进展失败？4)我们如何对标准操作程序结果的关键驱动因素进行因果建模

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