title: Assessments and admissions during the first 6 years of a UK medium secure DSPD service.
abstract: BACKGROUND
  Offenders with personality disorder represent a considerable burden on mental health and criminal justice services. Millfields Unit was one of the pilot medium secure units (MSUs) established by the UK Department of Health and Ministry of Justice to provide dedicated services for such individuals.
  
  
  OBJECTIVE
  Our study aimed to describe a complete cohort of referrals made to the service and to explore decisions on admissions to the Unit.
  
  
  METHODS
  File review was used to collect a structured data set of information on the first 158 referrals. These were then analysed descriptively and inferentially.
  
  
  RESULTS
  Previous psychological treatment in prison and evidence of motivation for further treatment were the strongest predictors of admission to the service. People admitted showed evidence of more extensive criminal histories, prior treatment failure and higher level of risk than those accepted into conventional medium secure units. Despite the stated purpose of the units being for people with personality disorder, a high number of patients with a primary diagnosis of psychotic illness were referred.
  
  
  CONCLUSIONS
  The new service accepted a high-risk group of people with personality disorder whose needs would not otherwise have been met.
authors.affiliation: Forensic Psychiatry Research Unit, Queen Mary, University of London, London, UK. m.c.freestone@qmul.ac.uk
authors.forename: Mark
authors.initials: M
authors.lastname: Freestone
authors.forename: Celia
authors.initials: C
authors.lastname: Taylor
authors.forename: Sophia
authors.initials: S
authors.lastname: Milsom
authors.forename: Chris
authors.initials: C
authors.lastname: Mikton
authors.forename: Simone
authors.initials: S
authors.lastname: Ullrich
authors.forename: Ophelia
authors.initials: O
authors.lastname: Phillips
authors.forename: Jeremy
authors.initials: J
authors.lastname: Coid
mesh_terms: D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D015331:Cohort Studies; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D015897:Comorbidity; D003617:Dangerous Behavior; D004608:Eligibility Determination; D006284:Health Plan Implementation / Q000331:legislation & jurisprudence / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training; D008131:London; D008297:Male; D008605:Mental Health Services / Q000331:legislation & jurisprudence* / Q000458:organization & administration*; D010552:Personality Assessment; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D010865:Pilot Projects; D011329:Prisoners / Q000523:psychology*; D011567:Psychiatric Department, Hospital / Q000331:legislation & jurisprudence / Q000458:organization & administration; D012008:Recurrence; D012017:Referral and Consultation / Q000331:legislation & jurisprudence / Q000458:organization & administration; D012637:Security Measures / Q000331:legislation & jurisprudence* / Q000458:organization & administration*