Violent offender treatment in a medium secure unit
| Pages | 102-111 |
| Date | 14 May 2018 |
| Published date | 14 May 2018 |
| DOI | https://doi.org/10.1108/JFP-06-2017-0019 |
| Author | Sharon Howden,Jayde Midgley,Rebecca Hargate |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Law enforcement/correctional,Public policy & environmental management,Policing,Criminal justice |
Violent offender treatment in a
medium secure unit
Sharon Howden, Jayde Midgley and Rebecca Hargate
Abstract
Purpose –The purpose of this paper is to conduct a preliminary evaluation of a Violent Offender Treatment
Program (VOTP) adapted for use in a medium secure unit (MSU). The patient population is adult male
mentally disordered offenders.
Design/methodology/approach –Patient outcomes are explored using the Reliable Change Index and
Clinical Significance Criterion. Outcomes are assessed using VOTP facilitators violence risk assessment
(VRS), multi-disciplinary team violence risk assessment (HCR-20 and GAS-V), and patient self-report using
two measures (FAVT and STAXI-2).
Findings –There was evidence of improved outcomes for some participants in some areas related to risk
of violence.
Research limitations/implications –Consideration is given to using varied risk assessments to evaluate
outcomes of an adapted VOTP for a MSU.
Originality/value –There is limited development and evaluation of psychological treatment programmes
that aim to reduce risk of violence for male offenders within MSUs. Outcomes of this evaluation could
influence treatment delivery and evaluation in other services.
Keywords Violence risk assessment, Medium secure unit, Violent offender treatment,
Mentally disordered offenders
Paper type Research paper
Introduction
The term “mentally disordered offender”(MDO) is used to describe a person who has a disability
or disorder of the mind and has committed or is suspected of committing a criminal offence
(Crown Prosecution Service, 2014). MDOs can commit a wide range of criminal offences,
although local figures within this NHS Foundation Trust have found violence to be higher than
other types of offending. In a high secure hospital within the Trust 72.3 per cent had committed a
violent offence (Braham et al., 2008). Similar breakdowns were found in the medium secure unit
(MSU) under study, with violence being the most prevalent form of conviction; 67 per cent in
2009 (Davies and Oldfield, 2009) and 63 per cent in 2017 (Oddie, 2017). There may be identified
risk factors for violence that are specific to MDOs and differ from those identified for other
offender populations. Some of these factors may be implicated in their mental disorder, such as
paranoia, delusions and high prevalence of co-morbidities such as personality disorder or
substance misuse (Howells et al., 2004). However, Blackburn (2004) notes that MDOs are a
heterogeneous group and whilst there is little disagreement that their mental health needs are
challenging for rehabilitation, there is less agreement as to whether mental disorder is a risk factor
for criminal or harmful behaviour.
Given the complexity of criminogenic problems and needs, MDOs may be difficult to treat and
manage, with low levels of motivation to engage in treatment often resulting in poor outcomes
(Braham et al., 2008). For example, high reconviction rates for violent offences amongst MDOs
have often been reported (Lund et al., 2013). Wong et al. (2012) commented that high-risk or
persistent offenders do not appear to cease re-offending altogether; rather they appear to
commit much less serious offences, which might suggest a significant harm reduction effect.
Received 4 June 2017
Revised 30 August 2017
7 September 2017
Accepted 7 September 2017
Sharon Howden is a
Psychology Team Lead and
Jayde Midgley is a Trainee
Forensic Psychologist, both at
Wathwood Hospital,
Rotherham, UK.
Rebecca Hargate is a Research
Manager at Leeds and York
Partnership NHS Foundation
Trust, Leeds, UK.
PAGE102
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JOURNAL OF FORENSIC PRACTICE
j
VOL. 20 NO. 2 2018, pp. 102-111, ©Emerald Publishing Limited, ISSN 2050-8794 DOI 10.1108/JFP-06-2017-0019
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