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Br J Psychiatry. 2012 Apr;200(4):336-41. doi: 10.1192/bjp.bp.109.068643. Epub 2012 Feb 23.

Costs and outcomes of an intervention programme for offenders with personality disorders.

Author information

1
Health Services and Population Research Department, King’s College London, Institute of Psychiatry, London, UK. barbara.m.barrett@kcl.ac.uk

Erratum in

  • Br J Psychiatry. 2012 Jun;200(6):514.

Abstract

BACKGROUND:

The dangerous severe personality disorder programme was developed in high secure prisons and hospitals at great expense to identify and treat the most dangerous offenders with personality disorders.

AIMS:

To evaluate whether the long-term costs of the programme are greater or less than the long-term outcomes.

METHOD:

We used a Markov decision model with a cost-effectiveness analysis to determine the incremental cost of the programme per serious offence prevented and a cost-offset analysis to consider whether monetary benefits were greater than costs.

RESULTS:

Costs were consistently higher for the intervention programme and the cost per serious offence prevented was over £2 million, although there was some evidence that adjustments to the programme could lead to similar interventions becoming cost-effective.

CONCLUSIONS:

Little evidence was found to support the cost-effectiveness of the intervention programme for offenders with personality disorders, although delivery of the programme in a lower-cost prison would probably yield greater benefits than costs. There are frequent calls for mentally disordered offenders to be detained in secure hospitals rather than prisons; however, if reoffending remains the outcome of interest for policy makers, it is likely that the costs of detention in hospital will remain greater than the benefits for dangerous offenders with a personality disorder.

Comment in

PMID:
22361021
DOI:
10.1192/bjp.bp.109.068643
[Indexed for MEDLINE]
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