AWARD WINNERS 2015-16: Sarah, a Probation Officer with NPS North West, based in Merseyside, and Julie, a Clinical Psychologist at Mersey Care NHS Trust, are described as “an inspirational duo”, and win an Award for their role in developing the innovative Psychologically Informed Consultation Service, which supports probation staff in the management and care of offenders with a personality disorder. [This Award is sponsored by Interserve.]

Sarah Kane, a Probation Officer based in Merseyside for the National Probation Service, North West (NPS NW), and Dr Julie Carlisle, a Clinical Psychologist for Mersey Care NHS Trust, have been jointly nominated for their role in developing a new project, the Psychologically Informed Consultation Service (PICS).

Lead nominator, Lynn Fletcher, Senior Probation Officer and Team Manager at PICS, explains the background. “Sarah and Jules were at the forefront of the development of a new project in Merseyside, PICS, as part of the Offender Personality Disorder pathway. This inspirational duo have demonstrated the importance and effectiveness of joint agency working… Initially they identified appropriate cases by screening the entire Probation caseload in Merseyside which amounted to hundreds of cases. Always up of for a challenge, they undertook this piece of work whilst continuously looking at ways to develop the service.”

The relevance of tackling Personality Disorders is pointed out by Local Butler Trust Champion Matthew Wakeman, Business Manager at NPS NW, who says that “around 70% of the prison population would be likely to meet the criteria for personality disorder, yet many have never had any specialist assessment or intervention.”

Sarah and Julie have been keen to “demystify working with complex needs”, says Lynn, and “together they have also developed workshops which they have offered to Court staff, Approved Premises staff and probation staff working solely with female offenders.  They are always presenting new ways to raise awareness of personality disorder and increase the skill set of the offender managers within the Probation Services.”

A further result of their success is an enhanced level of confidence among staff working with complex needs, which led to the PICs team being expanded to cover the whole of Merseyside.

Lynn continues, “They remain very passionate about the service and are keen to look at new opportunities aimed at developing staff awareness of personality disorder. In fact, owing to the glowing recommendations from Offender Managers, they have been able to encourage “buy in” from more reluctant colleagues, who have also provided feedback on how impressed they were about the service they received.  A recent commendation from a Senior Probation Manager described the service as ‘invaluable’.”

Indeed, “the service has such a good reputation because of the hard work Sarah & Jules have put in,” adds Lynn. “They are always eager to promote the service and provide help and guidance to colleagues.”

Matthew notes that “Sarah’s role as Probation Officer involves working jointly with Julie as psychologist, to assist Offender Managers in applying a psychologically informed approach to their work thereby providing a balance between managing “clinical advice” and criminal justice risk management support.” He describes Sarah as working “exceptionally hard to promote and deliver this service across Merseyside” and how Sarah “will regularly go above and beyond to ensure that they deliver a quality service and that the Offender Managers feels supported.”

At the start of the project, Sarah undertook initial screenings on high risk of harm cases, which involved looking at over 700 cases.  She simultaneously set out to promote the new service among staff. Matthew adds that “Alongside Jules, she has undertaken hundreds of hours of consultations and written psychologically informed formulations. She has also been involved in making the referral process easier for Offender Managers, making the service more accessible.” Sarah plays a helpful role in bridging the crucial gap between risk and service needs by seeking out appropriate pathways to effectively manage these issues.

Matthew says “Jules has been an integral part in promoting and implementing the PIC Service in Merseyside.  The service both Jules and Sarah have provided has been excellent [as they] assist offender managers who are having difficulty managing certain individuals.  As PICS has been so well received, Jules is now providing regular consultations at three of the Approved Premises across Merseyside.”

Because the service is not only for Offenders in the community, Matthew notes that “Jules has championed the need to ensure men close to or over tariff in Custody also benefit from psychological formulation.”

He points out that “Jules has provided psychological and risk work where brief structured intervention was identified as beneficial to the Offender. She has been pro-active in making referrals to services across the pathway. Jules’ role has assisted in linking mental health needs of Offenders and service needs, seeking appropriate ways to effectively manage obstacles and barriers to these issues.”

He concludes, “They are always looking for ways to develop the service and improve the management of offenders with personality difficulties. They both work extremely well together and as part of a wider team.”

Colleague Michelle Dean, a Senior Probation Officer at the South Liverpool Probation Centre (SLPC), describes how she has “found the PIC service at SLPC to be invaluable in both supporting staff  to develop strategies in managing some of our most difficult and challenging offenders but also in providing support and guidance to myself as a manager.” She describes how the team “are also held in the highest regard by staff in Liverpool South. The quality of the case consultation and formulation notes is outstanding and I enjoy reading through them and having discussions with my staff both within and outside of supervision.”

She goes on to cite an example of “a very challenging and high risk offender who, closer to release, will be managed as a MAPPA (Multi Agency Public Protection Arrangements) Level 3 and most likely a critical public protection case [where] Jules and Sarah highlighted strategies for risk management in the meeting, and their contribution greatly enhanced the understanding of professionals who attended and added a very valuable insight in regard to an understanding of the offender.”

Another colleague, Eddie Doherty, a Probation Officer based at Merseybank Approved Premises, lists several benefits from this work: “I have attended approximately ten PICS consultations with Jules and Sarah and individual offender managers in relation to men who are scheduled to reside at Merseybank. The benefits have been a consistency of approach from the Approved Premises and the OM, clear communication of risk and vulnerability concerns, and practical ways of managing difficult or challenging behaviour.”

Eddie also appreciates “the supportive and consensual approach taken by Jules and Sarah,” as “this makes the consultations a good forum for exchanging ideas, understanding hypotheses and asking questions. Jules and Sarah are very inclusive in their style of work. At Merseybank we feel that the service we provide to our residents has been enhanced and improved by the insights provided at the PICS consultation. We have also been able to improve the way we plan for arrivals and disseminate information among the team here.”

Deputy Director Roz Hamilton meanwhile calls Sarah and Julie “dedicated public servants who provide a unique and invaluable service to protect the public. Their understanding of serious offending related to personality disorder is second to none and their experience and knowledge inspires confidence amongst colleagues. This empowering style has resulted in a significant growth amongst staff in the level of understanding and appropriate intervention in this complex and important area of work. Such dedication undoubtedly needs recognition and thanks as a clear positive example of the NOMS vision of ‘preventing victims by changing lives’.”

Roz explains that “the framework uses a trauma informed approach, understanding the bio-psycho-social model of personality disorder to consider the most effective ways of safely managing the care of the offender. Offering such reflective space to Offender Managers enables them to be psychologically informed in their management and avoid relational strategies that could potentially be re-traumatising or enact difficult relational roles which may be unhelpful in case management.”

She cites “a common issue where the offender is in constant crises, and bids for crisis resolution (often emotional or practical help) which deflect from the practicalities of offence related work. This can lead to Offender Managers feeling overwhelmed, de-skilled, or that the risks of harm have escalated. Understanding the function of such behaviours in light of the world view and needs of the offender has helped the Offender Managers develop a sense of confidence in accepting and setting limits to the support and how it can be offered.”

As well as the impact of a “reported reduction in anxiety with respect to managing some high risk cases”, mentioned earlier, “Offender Managers have gone out of their way to commend the service and the impact it has made to how they feel in managing certain cases.”

Furthermore, Roz notes that “there has been no reported Serious Further Offending by those receiving consultation via PICS. For some, there has been a reduction in risk-tier and/or MAPPA level over the period of consultation. Some offenders have attracted Critical Public Protection Funding and referral to a Complex Case Review panel to determine appropriate pathways; the consultation process and resultant formulation has been important to this process.”

Looking ahead, Sarah and Jules are keen to promote greater access to joint working, using the resource and expertise of the psychologist or the specialist probation officer to support colleagues in their work.