People with personality disorders are to be found in all branches of psychiatric services, from the outpatient and community care through to acute inpatient care. Their behaviour is difficult, manipulative, threatening and they are hard to manage in institutional settings. Dangerous and Severe Personality Disorder is based on unique research study conducted in the three English high security hospitals - Ashworth, Rampton and Broadmoor. Through in-depth analysis of an extensive questionnaire survey followed by personal interviews, Len Bowers shows how positive or negative attitudes to PD patients arise and are maintained over time, as well as discusses what impact they have upon nurses and the care they provide to patients, and draws some practical conclusions. The difficulties facing staff who care for and treat PD patients are enormous, and constitute a significant personal challenge for the psychiatric professional of any discipline. For the first time this book provides details of the most effective ways of creating a positive context for working with personality disorder and contains a blueprint for training and organisational structures across the professional spectrum.

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.