The Peaks: A clinical service for those with dangerous and severe personality disorder

Abstract

Recent political initiatives in England and Wales have increased the focus on providing clinical services for personality disordered individuals. Increased attention on those identified as having dangerous and severe personality disorder (DSPD) has led to the piloting of specialist services to trial new assessments and interventions for the DSPD group in both health and prison settings. This article outlines the development and provision of clinical services for those within The Peaks, the DSPD pilot service within Rampton Hospital. The Peaks, the first new-build health-based unit, aims to provide a comprehensive service specifically focused on addressing the full range of clinical and criminogenic needs of those within the DSPD group. The philosophical underpinnings of the unit and the practical components of the service provided are described.

Evaluating innovative treatments in forensic mental health: A role for single case methodology?

“…This population's treatment needs are recognized to be complex and multidimensional, comprising both criminological and mental disorderrelated variables. DSPD units have dealt with this complexity by emphasizing the importance of individualized formulations and treatment planning (Hogue, Jones, Talkes, & Tennant, 2007). The combined effect of these factors is that multiple treatments are likely to be delivered at any site and to any one individual, in differing permutations, often in parallel and over extended periods of time.…”

Dangerous liaisons

“…In a recent article, Mullen (2007) argues that during the course of this evolution the emphasis has gradually shifted away from its 'populist' public safety origins towards a more therapeutic focus on developing effective interventions (see also Hogue et al, 2007). It has become, in his view, an exciting initiative but one that remains 'in flux' (Mullen, 2007: s6).…”

Difficulties in the pathway from high to medium secure services for personality-disordered patients

“…The DSPD Directorate within the hospital was established in March 2004 and houses approximately 50 inpatients. To fit within the DSPD service, patients must present a high risk of serious harm to others, have a severe personality disorder, and their level of risk and personality disorder must be functionally linked (Hogue, Jones, Talkes, & Tennent, 2007;Howells, Krishnan, & Daffern, 2007). The criterion for inclusion in this study was that the patient had been referred by their RMO 1 to a medium secure unit, on at least one occasion, between the introductions of the service and the date of data collection.…”