Purpose

This is a discussion paper describing the reflections of clinical leads within well-established intensive intervention and risk management services (IIRMS). IIRMS has developed in the past five years, with a small number of services leading in the development of a psychologically informed case management approach to working with individuals released from prison on probation licence, who have a history of high risk, high harm violent convictions linked to pervasive psychological and interpersonal problems.

Design/methodology/approach

Clinical leads of three services considered a period of 23 months up to December 2019, in which the outcomes for all individuals on their caseload at that time were reviewed. Reflections on the themes included the reasons for a premature return to prison and emerging themes for those who appeared to be successfully resettled.

Findings

Approximately one-third of the individuals were returned to prison, and for most, this occurred within the first 18 months of release. There was considerable unanimity between clinical leads regarding the themes, and problems with relative youth, substance misuse, relationship difficulties, managing transitions and complacency featured. There were four themes identified in those who appeared to have settled successfully in the community.

Practical implications

The identified themes provide key learning that will be enshrined in an updated version of the guidance for all IIRMS, with the overall aim of reaching out and engaging with a group of individuals who are most at risk of exclusion from services.

Originality/value

Although there are limitations associated with the informal approach of this paper, the reflections of the clinical leads have provided a valuable addition to the very limited empirical literature in this field.

中文翻译：

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强化干预和风险管理服务 (IIRMS) 三年后：我们需要在罪犯人格障碍途径中做得更好

目的

这是一篇讨论文件，描述了在完善的强化干预和风险管理服务 (IIRMS) 中临床线索的反映。IIRMS 在过去五年中得到了发展，少数服务引领了心理知情案件管理方法的发展，该方法与有缓刑许可证从监狱释放的个人合作，这些人有高风险、高伤害的暴力定罪历史普遍存在的心理和人际关系问题。

设计/方法/方法

三项服务的临床主管考虑了截至 2019 年 12 月的 23 个月期间，其中审查了当时所有个案中所有个人的结果。对这些主题的反思包括过早返回监狱的原因以及那些似乎已成功重新安置的人的新主题。

发现

大约三分之一的人被送回监狱，大多数情况下，这发生在释放后的前 18 个月内。关于主题的临床线索之间存在相当大的一致性，以及相对年轻、药物滥用、关系困难、管理过渡和自满的问题。在那些似乎已经成功融入社区的人中，确定了四个主题。

实际影响

确定的主题提供了关键学习，将载入所有 IIRMS 指南的更新版本，总体目标是与最有可能被排除在服务之外的一群人接触并与之互动。

原创性/价值

尽管本文的非正式方法存在局限性，但临床线索的反映为该领域非常有限的实证文献提供了宝贵的补充。