Assessments and admissions during the first 6 years of a UK medium secure DSPD service

Abstract

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. Our study aimed to describe a complete cohort of referrals made to the service and to explore decisions on admissions to the Unit. File review was used to collect a structured data set of information on the first 158 referrals. These were then analysed descriptively and inferentially. 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. The new service accepted a high-risk group of people with personality disorder whose needs would not otherwise have been met.