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Improving quality of life for patients is emerging as a legitimate goal for UK inpatient forensic mental health services. The Lancashire Quality of Life Profile (LQOLP), which has been used widely to measure well-being in community settings, was trialed on an inpatient population being cared for under conditions of high security. Two groups of male patients, drawn from within the same institution but with markedly different clinical conditions, i.e. schizophrenia (N = 47) and personality disorder (N = 48), were interviewed using the LQOLP. Although both groups had been cared for under largely similar environmental conditions over similar lengths of time (9.5 years), the subjective global well-being of the two groups differed systematically as did other objective and subjective well-being measures. However, analysis found that the variations in global well-being could not be attributed readily to factors covered by the interview, including either current mood or personality. Possible reasons for these findings and implications for the use of the LQOLP under conditions of high security are discussed.

INTRODUCTION: There are differing approaches to the management of people with a severe personality disorder in the UK and The Netherlands. Few comparative studies exist. This study describes the use of an adapted version of the Lancashire Quality of life profile as a patient based-outcome measure. METHOD: A cross-sectional sample of 37 patients was interviewed at each site. RESULT: Patients in the Dutch service reported a significantly higher quality of life which could not be explained by better objective circumstances. DISCUSSION: The data collected do not explain why the Dutch patients reported a higher quality of life. It is suggested that this finding was related to more extensive therapeutic activity and greater therapeutic optimism in the Dutch service. There is a need for critical scrutiny of the appropriateness of quality of life measures in offender patients before they are accepted for use as an outcome measure.

This was part of a larger project funded by grants from the High Security Psychiatric Services Commissioning Board and Department of Health.