Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders

Article


Fortune, Z., Barrett, B., Armstrong, D., Coid, J., Crawford, M., Mudd, D., Rose, D., Slade, M., Spence, R., Tyrer, P. and Moran, P. 2011. Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders. International Review of Psychiatry. 23 (1), pp. 61-69. https://doi.org/10.3109/09540261.2010.545989
TypeArticle
TitleClinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders
AuthorsFortune, Z., Barrett, B., Armstrong, D., Coid, J., Crawford, M., Mudd, D., Rose, D., Slade, M., Spence, R., Tyrer, P. and Moran, P.
Abstract

Personality-disordered offenders are difficult individuals to manage, and knowledge about effective treatment is sparse. In the UK, novel forensic psychiatric services were recently established for the treatment of offenders with personality disorder. In this paper we report the clinical and economic findings from a 2-year follow-up of a cohort of service users recruited from these services. Baseline information on developmental, clinical and offending histories was obtained from case records. Case records were checked at 6 and 24 months for new episodes of self-harm, violence, alcohol and substance use, and offending behaviour. Ratings of social functioning and therapeutic alliance were obtained from service users at baseline, 6 and 24 months. Fifty-six percent of service users were still engaged with the services at 24-month follow-up. Service users involved in the greatest number of behavioural incidents had greater impairment in baseline social functioning and lower IQ scores. There was no significant change in either therapeutic alliance or social functioning at 6 or 24 months. The economic analysis showed that although the services were predominantly run by the Health Service, there were considerable economic burdens shared by other service providers. Treatment costs at six-month follow-up were also significantly higher. Implications are discussed.

Research GroupCentre for Abuse and Trauma Studies (CATS)
LanguageEnglish
PublisherTaylor & Francis (Routledge)
JournalInternational Review of Psychiatry
ISSN0954-0261
Electronic1369-1627
Publication dates
Online21 Feb 2011
PrintFeb 2011
Publication process dates
Deposited29 May 2015
Output statusPublished
Digital Object Identifier (DOI)https://doi.org/10.3109/09540261.2010.545989
Permalink -

https://repository.mdx.ac.uk/item/8576x

  • 40
    total views
  • 0
    total downloads
  • 2
    views this month
  • 0
    downloads this month

Export as

Related outputs

Content moderator mental health, secondary trauma, and well-being: a cross-sectional study
Spence, R., Bifulco, A., Bradbury, P., Martellozzo, E. and DeMarco, J. 2024. Content moderator mental health, secondary trauma, and well-being: a cross-sectional study. Cyberpsychology, Behavior, and Social Networking. 27 (2), pp. 149-155. https://doi.org/10.1089/cyber.2023.0298
Supporting digital key workers: Addressing the challenges faced by content moderators during and after the COVID-19 pandemic
Martellozzo, E., Bleakley, P., Bradbury, P., Spence, R. and DeMarco, J. 2024. Supporting digital key workers: Addressing the challenges faced by content moderators during and after the COVID-19 pandemic. International Journal of Technology, Policy and Management. 24 (2), pp. 212-228. https://doi.org/10.1504/IJTPM.2024.137818
The psychological impacts of content moderation on content moderators: a qualitative study
Spence, R., Bifulco, A., Bradbury, P., Martellozzo, E. and DeMarco, J. 2023. The psychological impacts of content moderation on content moderators: a qualitative study. Cyberpsychology: Journal of Psychosocial Research on Cyberspace. 17 (4). https://doi.org/10.5817/cp2023-4-8
Moderating online child sexual abuse material (CSAM): Does self-regulation work, or is greater state regulation needed?
Bleakley, P., Martellozzo, E., Spence, R. and DeMarco, J. 2023. Moderating online child sexual abuse material (CSAM): Does self-regulation work, or is greater state regulation needed? European Journal of Criminology. 21 (2), pp. 231-250. https://doi.org/10.1177/14773708231181361
Content moderators’ strategies for coping with the stress of moderating content online
Spence, R., Harrison, A., Bradbury, P., Bleakley, P., Martellozzo, E. and DeMarco, J. 2023. Content moderators’ strategies for coping with the stress of moderating content online. Journal of Online Trust and Safety. 1 (5), pp. 1-18. https://doi.org/10.54501/jots.v1i5.91
Understanding sexual violence and factors related to police outcomes
Davies, K., Spence, R., Cummings, E., Cross, M. and Horvath, M. 2022. Understanding sexual violence and factors related to police outcomes. Frontiers in Psychology. 13, pp. 1-13. https://doi.org/10.3389/fpsyg.2022.977318
Impacts of the COVID-19 pandemic on reporting of rape, serious sexual offences, and domestic abuse in one English police force
Spence, R., Horvath, M., Dalton, C. and Davies, K. 2022. Impacts of the COVID-19 pandemic on reporting of rape, serious sexual offences, and domestic abuse in one English police force. Journal of Gender-Based Violence. 6 (2), pp. 242-260. https://doi.org/10.1332/239868021X16425806897258
Criminal court sentencing: the case for specialist ‘young adult’ courts
Ward, J. and Spence, R. 2022. Criminal court sentencing: the case for specialist ‘young adult’ courts. The British Journal of Criminology. 63 (4), pp. 1041-1057. https://doi.org/10.1093/bjc/azac076
The moderation effect of secure attachment on the relationship between positive events and wellbeing
Spence, R., Kagan, L., Nunn, S., Bailey-Rodriguez, D., Fisher, H., Hosang, G. and Bifulco, A. 2022. The moderation effect of secure attachment on the relationship between positive events and wellbeing. PsyCh Journal. 11 (4), pp. 541-549. https://doi.org/10.1002/pchj.546
Life events, depression and supportive relationships affect academic achievement in university students
Spence, R., Kagan, L., Nunn, S., Bailey-Rodriguez, D., Fisher, H., Hosang, G. and Bifulco, A. 2022. Life events, depression and supportive relationships affect academic achievement in university students. Journal of American College Health. 70 (7), pp. 1931-1935. https://doi.org/10.1080/07448481.2020.1841776
Understanding trauma in children and young people in the school setting
Spence, R., Kagan, L., Kljakovic, M. and Bifulco, A. 2021. Understanding trauma in children and young people in the school setting. Educational and Child Psychology. 38 (1), pp. 87-98.
The child attachment style interview (Child-ASI) and depression: preliminary findings
Bifulco, A., Jacobs, C., Oskis, A., Bunn, A. and Spence, R. 2021. The child attachment style interview (Child-ASI) and depression: preliminary findings. Educational and Child Psychology. 38 (1), pp. 62-74.
Life events and emotional disorder revisited: research and clinical applications
Bifulco, A., Spence, R. and Kagan, L. 2020. Life events and emotional disorder revisited: research and clinical applications. London, UK Routledge.
The long-term effects of childhood financial hardship mediated by physical abuse, shame, and stigma on depression in women
Spence, R., Nunn, S. and Bifulco, A. 2019. The long-term effects of childhood financial hardship mediated by physical abuse, shame, and stigma on depression in women. Maltrattamento E Abuso All’infanzia: Rivista Interdisciplinare. 21 (1), pp. 55-72. https://doi.org/10.3280/MAL2019-001005
Partner violence in women - associations with childhood maltreatment, attachment style and major depression
Bifulco, A., Damiani, R., Jacobs, C., Bunn, A. and Spence, R. 2019. Partner violence in women - associations with childhood maltreatment, attachment style and major depression. Maltrattamento E Abuso All’infanzia: Rivista Interdisciplinare. 21 (2), pp. 13-28. https://doi.org/10.3280/MAL2019-002002
Lifetime trauma, adversity and emotional disorder in older age women
Bifulco, A., Jacobs, C., Oskis, A., Cavana, F. and Spence, R. 2019. Lifetime trauma, adversity and emotional disorder in older age women. Maltrattamento E Abuso All’infanzia: Rivista Interdisciplinare. 21 (2), pp. 29-43. https://doi.org/10.3280/mal2019-002003
A contextual approach to trauma experience: lessons from life events research
Spence, R., Kagan, L. and Bifulco, A. 2019. A contextual approach to trauma experience: lessons from life events research. Psychological Medicine. 49 (9), pp. 1409-1413. https://doi.org/10.1017/s0033291719000850
Characteristics of severe life events, attachment style, and depression – Using a new online approach
Bifulco, A., Kagan, L., Spence, R., Nunn, S., Bailey-Rodriguez, D., Hosang, G., Taylor, M. and Fisher, H. 2019. Characteristics of severe life events, attachment style, and depression – Using a new online approach. British Journal of Clinical Psychology. 58 (4), pp. 427-439. https://doi.org/10.1111/bjc.12221
Web-based measure of life events using Computerized Life Events and Assessment Record (CLEAR): preliminary cross-sectional study of reliability, validity, and association with depression
Bifulco, A., Spence, R., Nunn, S., Kagan, L., Bailey-Rodriguez, D., Hosang, G., Taylor, M. and Fisher, H. 2019. Web-based measure of life events using Computerized Life Events and Assessment Record (CLEAR): preliminary cross-sectional study of reliability, validity, and association with depression. JMIR Mental Health. 6 (1). https://doi.org/10.2196/10675
Attachment style, loneliness and depression in older age women
Spence, R., Jacobs, C. and Bifulco, A. 2020. Attachment style, loneliness and depression in older age women. Aging and Mental Health. 24 (5), pp. 837-839. https://doi.org/10.1080/13607863.2018.1553141
Adolescent attachment style in residential care: the attachment style interview and vulnerable attachment style questionnaire
Bifulco, A., Jacobs, C., Ilan-Clarke, Y., Spence, R. and Oskis, A. 2017. Adolescent attachment style in residential care: the attachment style interview and vulnerable attachment style questionnaire. The British Journal of Social Work. 47 (7), pp. 1870-1883. https://doi.org/10.1093/bjsw/bcw117
Help-seeking in emerging adults with and without a history of mental health referral: a qualitative study
Spence, R., Owens-Solari, M. and Goodyer, I. 2016. Help-seeking in emerging adults with and without a history of mental health referral: a qualitative study. BMC Research Notes. 9 (1). https://doi.org/10.1186/s13104-016-2227-8
Factors associated with variation in hospital use at the end of life in England
Bardsley, M., Georghiou, T., Spence, R. and Billings, J. 2019. Factors associated with variation in hospital use at the end of life in England. BMJ Supportive & Palliative Care. 9 (2), pp. 167-174. https://doi.org/10.1136/bmjspcare-2015-000936
Measuring life events and their association with clinical disorder: a protocol for development of an online approach
Spence, R., Bunn, A., Nunn, S., Hosang, G., Kagan, L., Fisher, H., Taylor, M. and Bifulco, A. 2015. Measuring life events and their association with clinical disorder: a protocol for development of an online approach. JMIR Research Protocols. 4 (3), p. e83. https://doi.org/10.2196/resprot.4085
Focus on: antidepressant prescribing trends in the prescribing of antidepressants in primary care
Spence, R., Roberts, A., Ariti, C. and Bardsley, M. 2014. Focus on: antidepressant prescribing trends in the prescribing of antidepressants in primary care. Nuffield Trust.
Item response theory and validity of the NEO-FFI in adolescents
Spence, R., Owens, M. and Goodyer, I. 2012. Item response theory and validity of the NEO-FFI in adolescents. Personality and Individual Differences. 53 (6), pp. 801-807. https://doi.org/10.1016/j.paid.2012.06.002
The longitudinal psychometric properties of the EAS temperament survey in adolescence
Spence, R., Owens, M. and Goodyer, I. 2013. The longitudinal psychometric properties of the EAS temperament survey in adolescence. Journal of Personality Assessment. 95 (6), pp. 633-639. https://doi.org/10.1080/00223891.2013.819513
An evaluation of new services for personality-disordered offenders: staff and service user perspectives
Fortune, Z., Rose, D., Crawford, M., Slade, M., Spence, R., Mudd, D., Barrett, B., Coid, J., Tyrer, P. and Moran, P. 2010. An evaluation of new services for personality-disordered offenders: staff and service user perspectives. International Journal of Social Psychiatry.