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

Lead Research Organisation: Queen Mary University of London
Department Name: Wolfson Institute

Abstract

Personality disorder is a complex mental health condition
that can involve severe deficiencies in relationship skills,
identify dysfunction and, in extreme cases, a risk of physical
harm to others (1). Personality disorder is a prevalent
diagnosis in the UK (2). Estimates suggest between 4.4 and
13 percent of the general population could meet the criteria
for any personality disorder diagnosis (3). Within the criminal
justice system (CJS), personality disorder is overrepresented
with estimates suggesting 65% of male prisoners meeting
the criteria (4). Due to the prevalence, personality disorder is
a prominent issue with the CJS. Stemming from the
challenging and complex nature of personality disorder,
professionals are often unwilling to work with or experience
burnout through working with the population (5,6,7).
However, treatment and intervention with this population is
possible but research in the area is generally
methodologically poor (8,9).
The Offender Personality Disorder Pathway (OPD Pathway)
The Offender Personality Disorder Pathway (OPD Pathway) is
a joint initiative between the UK Ministry of Justice and NHS
England to provide psychologically informed services across
the CJS for high risk offenders who are likely to have a
diagnosis of 'personality disorder' (10). The pathway is based
on a whole systems approach, recognising the various
stages of an offender's journey from sentence through
prison and/or NHS detention to community-based
7 / 11
supervision and re-settlement. The aims of the OPD Pathway
are to reduce re-offending, improve offender psychological
health and wellbeing as well as improve the confidence, skills
and attitudes of staff working with personality disordered
offenders (10).
The OPD pathway has a national coverage across probation
and adopts a formulation-based approach, as well as
specialist psychologically informed, intervention services
from Category A prisons through to the community for
example, democratic therapeutic communities and
Psychologically Informed Prison Environments (PIPEs) across
custody and community Approved Premises. The previous
Dangerous and Severe Personality Disorder (DSPD)
government strategy was not cost-effective and so the
funding was redistributed to form the current OPD Pathway,
aiming to cover more of the needs of personality disordered
offenders (11).
There is currently only one OPD Pathway open prison (male),
at HMP Standford Hill. The service, known as Pathways
Enhanced Resettlement Service (PERS), has a focus on high
risk offenders who have a high likelihood of 'failing' in the
short-term, either reoffending or being returned to a secure
prison environment. The aim of the PERS service is to shift
psychological to practical hazards, modelling community
settings as much as possible. Service users can spend up to
two years in service with the aim of release into the
community. The OPD Pathway has been successful in
obtaining funding for an additional three open prison sites, in
accordance with the PERS model (two of which will take on
sex offenders) over a period of three years.
The Research Question
For my PhD research, I will undertake a mixed-method
evaluation, including advanced quantitative modelling,
across all four OPD pathway open prison services. The
research will aim to answer the overarching question; are
open prison (male) OPD services effective? There are four
specific research questions:
1) How do prisoners accepted into specialist open prison
services (SOPS) differ from a comparison group of offenders
transferred to standard open prisons?
2) What factors differentiate those who successfully progress
from SOPS from those who are returned to closed conditions
and/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 outcomes
from SOPS

Publications

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Studentship Projects

Project Reference Relationship Related To Start End Student Name
ES/P000703/1 30/09/2017 29/09/2027
2322775 Studentship ES/P000703/1 30/09/2019 31/12/2022 Georgina Mathlin
 
Description PERS evaluation summary
Pathways Enhanced Rehabilitation Services (PERS) are the OPD Pathway service offering within the open prison estate. Initially set up as a pilot, a longitudinal evaluation programme was set up to identify whether the service could be set up as intended and whether there was any early evidence that PERS is achieving its intended outcomes. The overarching research question was:
Do open prison PERS reduce failures for offenders on the OPD pathway and what factors are involved with successful progression through PERS?
The evaluation comprised 4 studies but concluded as two, mixed-methods evaluations to enable a focus on process (is the service being delivered as intended) and outcomes. This summary provides the headline findings of each. The full write up, including details around the methodology of studies is available upon request.
Process evaluation
The qualitative strand of the process study involved interviews with staff (N=9) to identify how PERS staff think service users successfully progress through PERS. As the study took place immediately following the relaxing of pandemic rules, the potential impact of COVID was also explored. The quantitative strand was descriptive, exploring how people progress through PERS and whether the people using PERS were those intended.
The qualitative study concluded:
• Staff considered success as relative and non-linear
• Staff felt relational aspects of the service (relationship building, support and advocating for service users) was key to service user success.
• Operational, and individual factors were also identified in relation to successful progression. Being adaptable and avoiding negative coping mechanisms were linked to success while a sense of hopelessness was identified as a key barrier.

The quantitative, process evaluation identified that at the time of the study:
• the key characteristics of the PERS population included white, middle aged, IPP/life sentences with a current medium risk of reoffending.
• PERS users had a low level of self-harm and substance use reported in the 6 months prior to starting PERS but a high proportion of the people had struggled with self-harm or suicidal ideation (over 50%) and drug use (over 80%) in the past.
• There was a sub-group of service users with high psychological distress.
• Nearly all the PERS population met the OPD screening criteria.

Overall, the process evaluation indicates the PERS population largely match the intended population for the service, but not exactly. However, this is limited by a lack of data on some variables. It would be useful to consider the wider context of the open prison populations and whether the PERS population is more 'risky' than the general open prison population. However, wider data on open prisons is extremely limited.
A logic model was created and reviewed with staff to capture the process of change thought to occur in PERS. Outcomes evaluation
The qualitative strand of the outcomes evaluation consisted of current and ex service user interviews (N=9) to identify how they would explain their successes (successfully finishing the service, being in the community offence free or remaining in the open prison for longer than prior stays), failures (being returned to closed conditions) as well as their overall experience of using PERS, including the impact of COVID-19.
The study concluded:
• Service users expressed differences in their willingness to integrate into PERS. Choice, transparency and short initial sessions were key to engaging more reluctant service users.
• All service users in the study expressed developing positive, trusting relationships with PERS staff (contrary to research in the wider open prison estate). Many service users expressed frustration over poor relationships with non-PERS staff in the open prisons.
• Service users felt PERS helped with the transition into the open prison environment and into the community. Changed perceptions of self was important for successful progression.

The quantitative strand of the evaluation aimed to identify whether using PERS increases the likelihood of remaining in open conditions, reduces the risk of return to closed and reduces the risk of recall from the community.
The study concluded:
• PERS were associated with a reduced risk of return to closed conditions.
• PERS tended to hold on to people longer (delayed release to the community).
• However, when adding type of open prison (prison with a PERS vs prison without), the effects above were removed. In other words, if return to closed conditions and release to community were looked at across all individuals in open prisons, any individual in a prison with PERS was less likely to be returned to closed conditions and have a delayed release to community, irrespective of whether they had been in a PERS or not.

It should be noted that including reoffending data was beyond the scope of this evaluation. Recall data was identified but not taken further for analysis as the number of recalls was too low to include in analysis, suggesting too short a time period to look at these long-term outcomes.
All study findings were synthesised into an emergent causal model, with 8 factors related to successful completion of PERS.
This was tested quantitatively, showing that service duration and prior OPD service use were the strongest influences on successful progression in the partially tested model. Psychological distress and high reoffending risk were the biggest predictors of unsuccessful completion. However, there were indications that service duration could help with this - the longer someone was in a service, the more likely high risk individuals would be successful.
Exploitation Route The evidence to date suggests that PERS are being successfully implemented and that there is evidence of early outcomes. In addition, people in PERS open prisons are significantly less likely (59%) to be returned to closed conditions compared to people in standard open prisons.
However, the longer-term outcomes are either unclear or remain to be investigated. Should funding continue for these services, it is strongly recommended that further funding is given towards evaluation, specifically to design and conduct a robust evaluation looking at survival in the community (including variables that were not factored in previously and an analysis of reoffending/recall).
Sectors Communities and Social Services/Policy

Government

Democracy and Justice

 
Description The findings of this award have contributed to the ongoing commissioning of the PERS services.
Sector Government, Democracy and Justice
Impact Types Policy & public services