Evaluating the impact of the London Pathway Project

TY - JOUR

T1 - Evaluating the impact of the London Pathway Project

AU - Jolliffe, Darrick

AU - Cattell, Jack

AU - Raza, Annabelle

AU - Minoudis, Philip

N1 - Funding Information: Offenders with personality disorders are disproportionately involved in serious and violent offending (Coid et al.,) and pose complex challenges to those tasked with managing and reducing their risks. These challenges include, but are not limited to, identifying those with personality disorder (PD), assessing the type and symptomatology of their PD and understanding how this might link to their offending, and selecting interventions and/or offending behaviour programmes that might reduce the risk of their offending (e.g. Minoudis et al.,). An intermediate goal of treating offenders with PDs is to ameliorate the impact of the PD on their day-to-day life to improve their well-being. Linked to this, the ultimate goal is to reduce the individuals' risk of harm (RoH) to themselves and others and to reduce their risk of reoffending (Craissati et al.,). These challenges are multiplied when attempting to address the needs of all potential personality disordered offenders in England and Wales (see Minoudis and Kane, 2017 and Skett et al., 2017, this volume). Prevalence estimates from the Department of Health and the National Offender Management Service (NOMS), the bodies responsible for offenders with PD in England and Wales, suggested that approximately 50% of offenders managed by NOMS could be identified as personality disordered (117,000 of 234,140 men and 12,000 of 24,577 women), and of these PD offenders, three to four per cent would be assessed as high or very high risk of causing serious harm to others (Joseph and Benefield,; Skett et al., 2017). Unfortunately, the evidence base for the effective treatment of PDs is insufficient (e.g. Bateman et al.,), and this is even more so the case amongst offenders with PDs (e.g. Livesley,; Khalifa et al.,). The London Pathways Project (LPP) is a consortium of four NHS Trusts delivering the Community Pathways service across London in collaboration with the National Probation Service: London Division. Although called the Community Pathways service, this service provides for both those offenders serving sentences in the community and in prison. For a more comprehensive review of the background and development of the LPP and the government's overarching Offender Personality Disorder (OPD) strategy, see Minoudis et al., 2017 and Skett et al., 2017, both in this issue. One of the higher level aims of the OPD strategy is to reduce reoffending, in particular, repeat serious sexual and/or violent offending, and one of the key methods of attaining this was to attempt to improve offenders' access to, and progression through, services and ensure effective risk management. These aims are proposed to be achieved through earlier post-sentence identification of offenders with severe PDs, improving sentence planning for these offenders (through assessment and case formulation), and improving access to interventions and treatment services. Treatment gains made by such offenders were to be new progression environments in prisons and approved premises, where offenders can be provided with post-treatment support in their move towards safer management in the community. This is a whole systems approach where the PD offender is identified early on post-sentence and an offender manager constructs a Pathway plan, supported by health service staff (usually psychologists), tracing the offender's journey through services. The Pathway is broader than a treatment model, as the core idea is to assist the offender to make positive life choices that will reduce risk and improve health and well-being (see Minoudis and Kane, 2017 and Skett et al., 2017, this volume). Previous research has examined the efficacy of various components of the pathway, such as the identification of those with severe PD (Minoudis et al.,; Shaw et al.,) and case consultation (Minoudis et al.,). There has also been an evaluation of the LPP pilot programme, 2 years after implementation in four areas of London (Minoudis et al.,). In this study, all probation cases were screened for high RoH and PD. A total of 742 offenders were identified, but the research focused on the 341 who had received more intensive input. A total of 68% had a sexual or violent index offence, and 87% were of high or very high RoH. After they were identified, the sample of PD offenders was provided with various levels of support, ranging from providing probation officers with strategies to engage with these offenders, to recommending specific custodial or community pathways. At least in part because of practical limitations (i.e. availability of places), of the 341 offenders, less than half (46%) were moved into specific services in secure settings or the community over the 2-year period. There was evidence to suggest that offenders who were contacted by telephone by psychologists were more likely to enter services, but the causal mechanism for this relationship was unclear. This paper extends the previous work by examining the impact of the full LPP Community Pathways service implementation after it had been in operation for at least 2 years across London. It is important to note that this was not an examination of the impact of a specific intervention with a clearly defined sample, but instead an evaluation of the impact of an overall approach with a heterogeneous population of high-risk, potentially high-harm men. Practical constraints were also placed on this evaluation, for example, because of the different starting points of the population (e.g. some commencing long prison sentences, some in the community), and because of the data available was administrative and not specifically collected for evaluative purposes. The key metrics of impact available for this evaluation were available in Offender Assessment System (OASys) and included changes in criminogenic needs (such as alcohol use or criminal thinking; Moore, 2015), risk of reoffending measures [Offender General Predictor (OGP), Offender Violence Predictor (OVP; Howard,)] and RoH (a perceptual measure of the potential harm of a reoffence; Morton, 2009). When conducting such evaluations, the presence of a control or comparison group, similar on key features to the group receiving treatment (in this case, those identified for the pathway), is essential. A comparison group allows for an assessment of the counterfactual, by providing a view of what might have happened had the pathway not been in operation. Research Questions: Were there desirable changes in the criminogenic needs of those identified for the pathway from their first OASys assessment after identification for the Community Pathways service to their most recent assessment? Were there desirable changes in the risk of reoffending and/or risk or harm for those identified for the pathway from their first OASys assessment after identification for the service to their most recent assessment? Were these changes different from those of a matched group of offenders over a similar period of time? Publisher Copyright: Copyright © 2017 John Wiley & Sons, Ltd.

PY - 2017/7

Y1 - 2017/7

UR - http://www.scopus.com/inward/record.url?scp=85021813069&partnerID=8YFLogxK

U2 - 10.1002/cbm.2041

DO - 10.1002/cbm.2041

M3 - Article

C2 - 28677902

AN - SCOPUS:85021813069

SN - 0957-9664

VL - 27

SP - 238

EP - 253

JO - Criminal Behaviour and Mental Health

JF - Criminal Behaviour and Mental Health

IS - 3

ER -