The topic of this symposium is the evaluation of outcomes in individuals presenting with violent or sexual offending in a range of different settings. Violent offenders are of particular concern to psychiatrists who may face pressure from society to detain such individuals. At the same time evidence for the efficacy of any interventions to improve outcome and reduce re-offending remains limited. In recent years new initiatives (e.g. the programme for Dangerous and Severe Personality Disorders (DSPD) in the UK) have been developed to understand better what works for violent offenders, including those with personality disorders. Research in this area is complex not least as randomised controlled trials might not be seen as practical or ethical.

This symposium comprises speakers from three different countries, Sweden, Switzerland and UK. The Swedish contribution will present data from a naturalistic study comparing offenders with mental disorder and substance misuse who engage in community treatment following release to those who don’t. Researchers from Switzerland will introduce the “therapy evaluation project” of the Zurich Criminal Justice System and show data on recidivism (both convicted and non-convicted). Presenters from the UK are from one of the high secure DSPD sites and will present different methodologies, including single case studies, to evaluate the efficacy of this service and its different therapies. The implications of these findings for future research and service delivery will be discussed.