Working with personality disordered offenders – A practitioner’s guide.

pdf-addThis guide was prepared by Oxleas NHS Foundation Trust in collaboration with Camden & Islington NHS Foundation Trust. It was funded by the Department of Health and the National Offender Management Service..


Personality disorder is a recognised mental disorder. Studies have estimated that it affects between 4 and 11% of the UK population and between 60 and 70% of people in prison. Until recently personality disorder was neglected by services and often regarded as untreatable. However, the National Institute for Clinical Excellence has published guidance on management and treatment and, gradually, more services are recognising and catering for this disorder. The evidence base is developing and the prognosis is no longer as negative as once thought.

This guide has been produced to support offender managers. However, it is likely to be useful for others, including social workers, psychologists, prison officers, drug and alcohol agency staff and mental health nurses working in community and secure settings.

It provides information about personality disorder and practical advice on how to manage people who can be extremely challenging. It also considers the effect this work can have on staff wellbeing, identifying the signs and consequences, and suggesting how staff can protect themselves.

The guide is of particular use to staff working with offenders who present a high risk of violent or sexual offence repetition and of causing harm to others. Personality disorder is linked to these behaviours. It is also more likely to be present in offenders who:

  • End up being recalled to prison
  • Accumulate adjudications
  • Breach hostel rules
  • Drop out of or fail to make progress in accredited programmes
  • Make complaints about staff
  • Self-harm
  • Are transferred to secure NHS settings, and
  • Cause staff to go off sick.

This guide also supports the delivery of the Department of Health and National Offender Management Service strategy for offenders with personality  disorder. NHS and NOMS have a joint responsibility for this population and the needs of offenders with personality disorder can best be met through joint operations along a pathway of active interventions. This guide supports the frontline staff who work day-to-day to make the strategy a reality.