Edinburgh Napier University

  Background: Offenders with personality disorder are supported by health, criminal justice, social care and third sector
services. These services are tasked with reducing risk, improving health and improving social outcomes. Research has
been conducted into interventions that reduce risk or improve health. However, interventions to improve social outcomes
are less clearly defined.
Methods: To review the effectiveness of interventions to improve social outcomes we conducted a systematic review
using Cochrane methodology, expanded to include non-randomised trials. Anticipated high heterogeneity of the studies
informed narrative synthesis.
Results: Eleven studies met inclusion criteria. Five contained extractable data. No high-quality studies were identified.
Outcomes measured clustered around employment and social functioning. Interventions vary and their mechanisms
for influencing social outcomes are poorly operationalised. Although change was observed in employment rates, there
was no evidence for the effectiveness of these interventions.
Conclusions: There is a lack of evidence for effective interventions that improve social outcomes. Further research is
recommended to reach consensus on the outcomes of importance, identify the factors that influence these and design
theoretically-informed and evidence-based interventions.