People with personality disorders need better access to help and support throughout the criminal justice system, from first contact with the police to prisons and probation, according to a report published today by Centre for Mental Health.

Personality disorder and complex needs is the third and final briefing paper published by Centre for Mental Health on behalf of the independent Bradley Commission, reviewing progress in the implementation of the 2009 Bradley Report. It explores what support people with personality disorders get in the criminal justice system and looks at examples of good and promising practice across the country.

Two-thirds of prisoners and about half of people under probation supervision are estimated to have personality disorder traits, yet only a small proportion get any support.

The briefing paper commends the national Offender Personality Disorder Strategy which is extending support to more people in prison and outside whose personality disorders are linked to their offending. This has led to the creation of psychologically informed physical environments (PIPEs) in prisons, where staff have received training in working with people with a personality disorder, where treatments are offered and where relationships between staff and prisoners are key to success.

The briefing paper looks at a range of services inside and outside prison that support offenders with personality disorders. They include Resettle in Liverpool, which works with people who pose a high risk of harm in contact with probation services. They provide intensive support and promote social integration, with a crisis line out of hours.

The briefing paper calls on health and criminal justice services to work together to ensure effective interventions are offered at every stage of the criminal justice system to all offenders with a personality disorder.

Dr Graham Durcan, associate director for criminal justice at Centre for Mental Health, said: “Personality disorder is a controversial term, but people living with a personality disorder too often find themselves stigmatised, isolated and offered little if any help.

“Personality disorders are so common among people in prison that we need to see the whole system become psychologically informed. Putting the principles of PIPEs in place in all prisons and probation services could dramatically improve people’s health and reduce reoffending.”

Personality disorder is a controversial term, but people living with a personality disorder too often find themselves stigmatised, isolated and offered little if any help.
- Dr Graham Durcan


Lord Bradley, author of the Bradley Report and chair of the Commission, said: “The treatment of prisoners with a personality disorder is changing for the better. Reinvesting funds from the failing ‘dangerous and severe personality disorder’ units to create PIPEs and extend access to treatment shows that we can change the way we work to benefit more people. We now need to take the next step and offer all offenders with personality disorders hope of a better future.”