Clarke’s penal reform speech raised expectations that the review of sentencing and rehabilitation policy, due to report in October, will offer new ways of “reconciling drastic and necessary cuts in public spending with positive policy making”.
In trying to arrest the relentless rise in the prison population in England and Wales, Clarke also described the need to “provide the service that the public interest demands in a more targeted way”.
So it is refreshing to learn of a small but innovative project that is making a difference in one area that lies at the root of much public anxiety over the criminal justice system.
A partnership between Camden and Islington NHS mental health trust and the London probation service aims to reduce the number of high-risk personality disordered offenders from being recalled to prison after they have been released on licence into the community. The results so far have been impressive, with a 50% reduction in the number of offenders recalled to prison between September 2009 (when the scheme was fully up and running) and June 2010 compared with the same period the previous year.
The Impact project is based on the idea that people with a personality disorder are not getting dealt with either in prison or in the community. MoJ research shows that the level of neurosis and personality disorders is three times higher for those behind bars than among the general population, with 62% of male and 57% of female sentenced prisoners having a personality disorder.
Winifred Bolton, a consultant clinical psychologist, who is Camden and Islington’s clinical lead for personality disorder, helped to set up the project: “We found that 72% of ‘high-risk offenders’ recalled back to prison by probation officers from Camden and Islington last year, either had a diagnosis of personality disorder or were undiagnosed with a significant number of disordered personality traits,” she says.
People with psychiatric or mental illness are being recognised, says Bolton, but those with personality disorder, which she defines as chronic and persistent psychological dysfunction and emotional instability, are not being dealt with either at the point of sentence or when released into the community.
Bolton believes that the 50% reduction in recall rates has been achieved safely – ie with no further incidents. The project works by psychologists training frontline probation staff to improve their skills and to work more effectively with offenders who have a personality disorder so they can better refer their difficult cases to the mental health services rather than be relieved of them.
Concerns about risk
“Probation staff, who don’t necessarily speak the language of mental health, have experienced difficulties in making timely referrals to mental health services. NHS and third sector staff often have concerns about risk when they work with offenders,” says Bolton. “By bringing together expertise from both sides, we are able to bridge these gaps.”
It means that the psychologists get to understand the needs of probation staff in managing high-risk offenders in the community. It also gives probation officers a better understanding of personality disorder and ways to address offenders’ individual psychological needs.
Other projects, including a similar scheme in Liverpool, the Resettle project, involves psychologists working directly with offenders, but those behind the Impact project believe their approach can bring a wider response. They are also concerned that direct working by psychologists may relieve probation staff of some of their most difficult cases in the short-term, so it would result in “deskilling” probation staff in the longer term. A small number of cases do involve some direct working, for example, to provide a specialist psychological assessment.
The training package includes material dispelling some myths. That includes refuting the idea that offenders with a personality disorder are bad rather than have mental health issues, or that when they start shouting at their probation officer they are doing it because they are manipulative.
Although the numbers involved in the Impact project are small, the 50% reduction in recall rates – at a time when recalls have been rising – has saved £300,000 in its first year by ensuring those high-risk offenders were managed in the community rather than back in prison. Bolton says in the longer term it hopes to develop this partnership model so it is transferable to other parts of the country and possibly to other groups with complex needs.
It would be good if those MoJ officials could encourage such lateral solutions.