Personality Disorder: Bradley and Beyond

Nick Benefield & Nick Joseph

PD: 2003-2009RecognitionDifferentiation

Risking a complex partnership

Given Hope

Here to stay!

Bradley

1960s - DTCs 1999 - DSPD

2009 - review 2007 - stocktake

Consistency in recommendations and issues

PD workplan

Strategy & investment plan (2010)

Children & young people with conduct disorder

Very high risk of harm to others and SPD (3,000)

PD services in secure

MH (1,000) Current allocation of resources

A PLAN FOR THE DELIVERABLES :

A Cross Departmental StrategyA Service Framework

A Practitioner GuidePrison DTC Review

Psychologically Informed Planned EnvironmentsTraining and Education Strategy (KUF)

Investment Plan

Testing the Principles: audience consultation

• Offender PD population is accepted as a shared responsibility of the Criminal Justice System (Prison and Probation) and the NHS

• These offenders populations should be managed through managed through joint operations;

• Services are primarily based in the Criminal Justice System but requiring collaborative delivery between the CJS and NHS;

• Planning and development is on a whole systems pathway basis;

• Planning and development is on a

whole systems pathway basis;

• Staff receive appropriate support and training building on the Knowledge and Understanding Framework;

• Research focused on reducing risk, psychological health improvement and economic benefits

For those of high risk of harm to others:

audience consultation

Those with the most complex psychological needs who require specialist interventions are identified early and appropriate options included in sentence plans

Public protection is enhanced by addressing the

relationship between risk and

psychological needs

• Psychologically informed lifelong

management is essential where

this risk is associated with a

personality disorder.

Further Principles...No role for traditional psychiatryThe best evidence is for the intervention programmes run the

CJS; these will be improved if more attention is paid to the traits that underpin ASPD.

Some offenders will require a highly specialised service where their PD is directly linked to their risk to others.

A minority of indeterminate offenders will require lifelong detention and should be told so.

Offenders with PD should be sentenced at a criminal court and primarily treated in the Criminal Justice system

Treatment and recovery requires an focus on the social and relational context.

And Beyond...PD within mainstream NHS and Criminal JusticeFrom participation to involvementCommunity to community pathwaysPD KUF in core training of all key workforcesDevelopment of a new breed of professionalsPersonality in public mental health policyMaking more sense of offending - being more effective?Winning hearts and minds

Nick Joseph: nick.joseph@noms.gsi.gov.uk

Nick Benefield:nick.benefield@dh.gsi.gov.uk