Exploring offender personality disorder services within a high security prison setting

Bennett, Alice (2022) Exploring offender personality disorder services within a high security prison setting. Doctoral thesis, Northumbria University.

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Abstract

This commentary presents publications relating to personality disorder services based within UK high security prisons. The Westgate Unit was evolving when this work was conducted and continues to do so. This offered unique and valuable opportunities to conduct high quality applied research and produce publications relating to a unique, high profile service. Limited publications had been produced in personality disorder services within the Prison Service compared to health settings, leading to the requirement to address this limitation. The publications’ aims were to: (i) promote and communicate aspects of the service to internal and external professionals; (ii) inform stakeholder decision-making; (iii) inform practice and policy development, and; (iv) contribute to the literature-base. Varying methods are included within these submissions including a book chapter, descriptive publications, alongside qualitative and quantitative research studies. These publications were responsive to the limited available sample by the methods employed, particularly as large-scale research would not be feasible for a considerable time. The Westgate Unit’s research strategy was being developed during the time these publications were being completed, resulting in these works either generating ideas within the strategy or exploring areas identified within the strategy. The main take-home messages from the presented publications relate to: the complexity of the population and their treatment needs; the requirement for responsivity-informed treatment and management; and the importance of multi-disciplinary input within personality disorder services. More specifically, findings from the research presented within these publications included: a high level of co-morbidity between personality disorder and clinical disorder diagnoses; narcissistic personality disorder being predictive of treatment dropout; and prisoners located on a new progression service hoping to achieve both progression and becoming part of a community. The communication publications included shared: clinical and clinically-informed practices employed by the Westgate Unit (highlighting the importance of an eclectic model of treatment for personality disorder); clinical responses to change in national policy in substance use intervention; and how approaches initiated by the Westgate Unit have been transferred and applied to both small, discrete units and main location settings within the high security prison estate. Resultant from the work within these publications, the Westgate Unit expanded treatment-supportive services for this complex client group. Knowledge regarding the hopes and expectations of a new progression service informed the training and supervision of multidisciplinary staff and policy development. An (unanticipated) additional benefit from these works becoming published included networking opportunities both within and outside of the Prison Service and subsequent working relationships. Connections to local universities opened up mutually beneficial opportunities for the university and the prison. These publications made headway in terms of addressing gaps in the literature-base for prison-based personality disorder services and sparked further research.

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