Historically we have not known how to respond to offenders with personality disorder. In many respects all we have done is contain them, but this has failed to keep a hold of our anxieties. The Dangerous and Severe Personality Disorder (DSPD) Programme and four high security hospital and prison units for men have been developed in an attempt to reduce uncertainty and to help us 'know' more. Drawing from the case records of DSPD patients and prisoners and interviews with Parole Board (PB) and Mental Health Review Tribunal (MHRT) members this thesis explores how the journeys of patients and prisoners prior to and following DSPD admission are presented to the PB and MHRT, and how DSPD may impact on PB and MHRT decision-making. DSPD patients and prisoners share many similar characteristics, but following DSPD admission, some differences in their institutional responses can be identified. While the outcomes of PB and MHRT reviews with DSPD participants are different, the reviews serve many similar purposes. The uncertainty that surrounds DSPD disrupts PB and MHRT conceptions of what a normal journey through the criminal justice and/or mental health system looks like. We are not entirely certain who DSPD patients and prisoners have been, who they are, and who they may become. We do not know the extent to which DSPD treatment will reduce risk. Nor do we know how, or whether, DSPD patients and prisoners can progress to lower security facilities. Paradoxically, what we do know about DSPD, and the precautionary logic that structures DSPD, may serve to heighten our anxieties. It is this problematic terrain for decision-making, and journeys through managing the unknowable that this thesis explores.

The UK Government's Offender Personality Disorder (OPD) Strategy is one of the most significant developments in mental health and criminal justice in recent years. The challenges presented by personality disorder offenders are not unique to the UK and this book also provides a useful overview of developments in the UK for those working with this population in countries where health service provision and legal frameworks pose different challenges. Managing Personality Disordered Offenders: A Pathways Approach describes how the OPD Strategy has been implemented by a consortium of mental health trusts in the UK, in collaboration with the National Probation Service and the Prison Service. This volume covers the broad range of key tasks in developing and delivering an OPD service. This includes reviewing the political and clinical context and how it aims to address some of the criticisms levelled at previous initiatives developed to meet the needs of this population. In each chapter, the authors review the existing literature and discuss the various options that were considered during the development of each of the services. Through this lens, the reader gains a better understanding of the direction taken, followed by a detailed, practical "how to do it" guide.

The economic impact of society's attempts to rehabilitate and contain psychopathically disordered individuals can be enormous. Understanding the nature of these disorders, developing accurate and valid assessment methods, and providing effective treatment and safe management cannot be underestimated. Including contributions from an international panel of experts from Europe, North America, and Asia, this two-volume set offers an in-depth, multidisciplinary look at key aspects of the development and etiology of psychopathic disorders; current methods of intervention, treatment, and management; and how these disorders impact decision-making in civil and criminal law. The most comprehensive major reference work available on psychopathy and the law, The Wiley International Handbook on Psychopathic Disorders and the Law, 2nd Edition: Covers the full history and conceptual development of psychopathic disorders Provides unique and enlightening perspectives on the subject from some of the world’s most well-renowned professionals in the field Looks at the etiology and pathogenesis of psychopathic disorders Examines current methods for the intervention, treatment, and management of ADHD, antisocial behavior, and impulsive aggression Provides in-depth discussions of civil and criminal law issues The Wiley International Handbook on Psychopathic Disorders and the Law, 2nd Edition is a must-have reference for practitioners and academics in clinical psychology, forensic psychology, psychiatry, probation, law, law enforcement, and social work.

People with personality disorder who offend tend to be neglected by health services in most countries. In the UK, there has been renewed interest in the field since government initiatives in the end of the 1990s. Government proposals themselves are controversial, but there is growing recognition that it is unsafe, both for the general public and for the primary sufferer alike, if the neglect continues. Years of experience have combined to provide a highly practical reference work covering: ·Models of understanding of personality development and disorder ·Methods of assessment and treatment and how they can be applied and modified ·Special issues - drug misuse, long-stay induced secondary disorders, issues pertinent to women only, 'intractable' patients ·A path for care - from initial assessment to the logistics of discharge ·Management issues - choosing staff, supervision and support of staff Evidence-based and entirely comprehensive in its approach, practitioners will find Personality Disorder and Serious Offending both a practical and insightful adjunct that will assist them in their work.

Working Positively with Personality Disorder in Secure Settings provides a positive, compassionate and evidence-based guide to working with patients with personality disorders. Unique in both its coverage and in its positive and evidence-based approach to working with patients with personality disorders Written with a practical focus by experienced practitioners in the field Offers a broad approach, with contributions from forensic and clinical psychologists, nurses, and therapists Covers therapy and therapeutic relationships, and issues of supervision, workforce development, treatment evaluation, team dynamics and managing boundaries Includes a strong patient focus and a number of personal accounts from patients who have received therapy themselves

In 1999, policymakers in England and Wales advanced controversial proposals for the preventive detention of a group they termed 'dangerous people with severe personality disorders'. Against a background of uncertain scientific knowledge, legal and policy actors have long faced challenges in reconciling the need to prevent crime with the need to respect the rights of the 'dangerous'. Ailbhe O'Loughlin's book, Law and Personality Disorder, situates contemporary debates about 'dangerous' offenders within this decades-old battle between the proponents of liberal legal principles and advocates of social defence. Law and Personality Disorder deconstructs competing images of offenders with personality disorders and the dilemmas they present, combining insights from criminology, psychiatry, psychology, and law. The book thus critically engages with an alluring narrative: the state has a duty to protect the public from 'dangerous' individuals, but it can also protect the human rights of the 'dangerous' by providing them with rehabilitation opportunities. While human rights law is often invoked as a means of curbing the excesses of preventive justice, O'Loughlin demonstrates that the case law of the European Court of Human Rights tends to legitimise coercive measures. Criminal law, furthermore, enables the punishment of offenders with mental disorders by resisting psychiatric evidence that they may not be fully responsible for their actions. Examining gaps in sentencing law, mental health law, and human rights law, this innovative book offers readers a comprehensive interpretation of the laws governing offenders with personality disorders and puts forward proposals for reform.

This book provides an expert synthesis of these clinical advances. It covers the nature of personality disorders, assessment, diagnosis and classification, management and a broad range of therapeutic approaches. Written by practitioners with real expertise in the field, the book is equally suitable for psychiatric trainees and more experienced clinicians from the full range of disciplines in mental healthcare. Up to date and comprehensive. Includes service user experiences. Draws on a wealth of real clinical experience. Eclectic range of therapies and approaches. Covers all age groups and specialist settings. Five chapters have been specially commissioned for this book, while previous versions of the other 15 chapters have been published in the journal Advances in Psychiatric Treatment - many have been extensively updated by the authors.