Ethnicity and Pathway Progression: A Retrospective Cohort Study of Male Offenders Managed Under London Offender Personality Disorder Pathway Services

Abstract

Background

In the United Kingdom, the Offender Personality Disorder (OPD) Pathway provides a psychologically informed pathway of services—from screening to formulation to referral to treatments/interventions—for men and women whose offending is linked to their complex mental health needs. Evidence shows that individuals from most ethnic minority groups in the United Kingdom are over-represented at all stages of the criminal justice system (including arrests, cautions and convictions). Such individuals may, however, be disadvantaged in terms of their access to and engagement with this specialist service.

Aim

To examine the extent to which self-reported ethnicity was associated with progression through discrete stages of the OPD Pathway in London.

Methods

Linked administrative data from 8816 men who screened into the OPD Pathway from 2011 to 2022 were used to examine the association between self-reported ethnicity (categorised as White, Black, Asian or mixed) and the last known recorded Pathway stage (screened-in and no further work, case consultation/formulation, referral to services, accessing service and completion).

Results

Adjusting for baseline risk, time on the OPD Pathway and London borough, we found that those who self-identified as Black (compared to White) were under-represented at all stages of the Pathway (compared to baseline), suggesting that these individuals tended to get ‘stuck’ at the early Pathway stages.

Conclusions

These findings add weight to suggestions of probably disproportionate disadvantage among men identifying as Black in accessing important dedicated services for offenders with personality disorder. Our data have been used to inform exploration of programme changes, and next steps will include exploration of what has driven this under-representation of non-White ethnic groups across the service and whether more sensitively informed strategies can improve equitable access and benefits.