The development of a specialist hostel for the community management of personality disordered offenders.
BACKGROUND
Since the late 1990s, in England and in Wales, there has been increasing interest in the particular challenges of managing offenders with personality disorder (PD). In 1999, a specialist hostel, managed by the probation service but with a high level of forensic mental health service input, was opened to high-risk PD offenders.


OBJECTIVE
To describe the first 93 high-risk residents with PD who were completing sentences under life licence, parole or probation, and their outcome.


METHODS
We investigated the nature of the offences residents had previously committed, their psychological profile in terms of personality patterns on the Millon Clinical Multiaxial Inventory (MCMI-III) and the Psychopathy Checklist-Revised (PCL-R), as well as staff commentary on their progress, to establish whether these factors related to outcome in terms of completion of stay in the hostel or premature discharge. Curfew failures and rearrest rates were also measured.


RESULTS
Of the 80 men who completed their residency within the two years of the study, the majority (50) left the hostel for positive reasons under mutual agreement. One-fifth were rearrested while resident, which is a lower rate than would be expected for such a group of offenders. PCL-R scores were predictive of outcome, but so was previous offending history. Self-defeating traits on the MCMI-III and negative comments written by hostel staff were also associated with failure.


CONCLUSIONS
The hostel development demonstrated that probation and health services can work together to manage violent offenders with high levels of psychological dysfunction, and the evaluation provided some indications of how such arrangements might be enhanced.
Blumenthal
Stephen
S
Portman Clinic, Tavistock and Portman NHS Trust, London, UK. sblumenthal@tavi-port.nhs.uk
Craissati
Jackie
J
Minchin
Louise
L
D000328:Adult; D000987:Antisocial Personality Disorder / Q000534:rehabilitation*; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003688:Deinstitutionalization / Q000379:methods*; D004739:England; D005555:Forensic Psychiatry / Q000379:methods*; D006208:Halfway Houses / Q000379:methods*; D006801:Humans; D033183:Interdisciplinary Communication; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D012917:Social Adjustment; D012931:Social Environment; D016896:Treatment Outcome