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This paper reports on the first eight years of a community‐based forensic team for people with learning disabilities. The authors give an overview of current research and government guidance regarding the prevalence, care pathway and treatment of people with learning disabilities who offend. The role and function of the community forensic team is described and an analysis of referrals to the service is given. The authors reflect on the frustrations as well as the achievements associated with providing this service.

This article reviews the literature on personality disorder in offenders with learning disabilities, using Medline, PsychoInfo and CINAHL databases, and search terms ‘offending’, ‘personality disorder and intellectual disabilities’, ‘learning disabilities’ and related terms. Methods of defining offending population, personality disorder and learning disabilities vary greatly, and few studies focus specifically on personality disorder, learning disability and offending. The definition of learning disability often encompasses both borderline learning disability and low average intelligence. Personality disorder, especially anti‐social personality disorder, is prevalent in offenders with learning disabilities, but less than in the general population, and is associated with higher levels of security and poorer outcomes. The study concludes that there is a continuum of offenders with borderline and mild learning disabilities, reflected in learning disability forensic services.

High levels of anger have been associated with forensic learning disabled populations. The role of gender within the experience of anger is not clear. This study aims to start exploring the question “Do female forensic patients with learning disabilities have different needs in relation to anger?”

This study used a between‐subjects design with one independent variable: gender. The Novaco Anger Scale and Provocation Inventory was applied. Scores obtained by 12 females were compared with those of 23 males within a forensic psychiatric service for learning disabled patients.

Significant differences were found between scores, suggesting female forensic patients with learning disabilities experience higher levels of anger than do males, particularly in the arousal domain, and demonstrate difficulties in regulating anger.

The use of a single measure of anger and the small, forensic nature of the sample limits this study. It is recommended that further research address these issues and extend the exploration of this issue to non‐forensic populations.

Gender specific differences, and the potential influence of learning disabilities should be considered when assessing and treating anger difficulties. Female forensic patients with learning disabilities may benefit from a greater emphasis on anger arousal reduction work.

This study highlights how the impact of gender and learning disabilities on the experience of anger is currently insufficiently understood.

This study forms a preliminary study of anger in the under‐researched population of females with learning disabilities.

This paper describes the ideas related to forensic practice with people with learning disabilities through a study that explores the apparent ‘truths’ about people with learning disabilities who are detained in forensic settings (referred to here as ‘the men’) and the staff who work with them by an analysis the dialogue contained in retrospective data from interviews and focus groups.The men in these settings are subject to intense stigma and disadvantage; socially and legally. Not only are they categorised as having a learning disability, but also have the added stigma of being offenders, and commonly having mental health issues that expose them to the worst of myths surrounding learning disability; such as the possibility of being viewed as ‘dangerous monsters and sex fiends’ (French & Swain, 2008). Similarly, but to a lesser degree, forensic nurses are stigmatised and subject to strict laws, policies and practices and stereotyped as prison wardens and ‘tough guys’. These ideas may be exposed and challenged through studying the discourses in the dialogue. Therefore, the general research questions included the following.• What are the discourses related to learning disability and forensic practice?• What ideologies underpin and justify forensic practice?This paper is primarily concerned with the way that the staff and the men experience the medium secure unit (MSU) and their views as to the advantages and disadvantages of secure care.The findings generally suggest that the men and the staff are very positive about their lives.They report that the men have many attributes and talents, and view having a learning disability as an advantage at times; the staff enjoy their work and have good relationships with the men. Paradoxically1, there are also negative discourses identified, some of which permeate from macro ideologies into policy and practice to justify the men's treatment in the MSU.The analysis showed that despite the certainty that many feel about the justifications for holding men with learning disabilities in secure settings, many paradoxes exist in the discourses in this setting, which question the validity of official knowledge in this area ‐ this is essentially a Foucauldian idea (Foucault, 1975). Foucault's ideas on the way that knowledge and practice may be challenged are important to this paper.

This paper reports on the first three years of a community forensic team in Birmingham working with individuals with learning disabilities who have offended or are at risk of doing so. Using an interprofessional model, the team provided assessment, intervention and management, enabling individuals to live in the least restrictive environment. There were 113 referrals, the majority (94%) of whom were males. Only 26 had been convicted. The problems this raised for the team are discussed, along with the cost‐effectiveness, impact on admission rates and benefits of providing such a service. Two case scenarios are presented to highlight some of the issues encountered by the team. The paper supports the development of such services.

The purpose of this paper is to complete a thorough needs assessment that would enable the development of a robust pathway of care for adults with a learning disability requiring secure care, and to assist commissioners to make informed planning decisions.

The paper identified people with a learning disability originating from London who were in secure care, and collected data about them. The paper used reference groups to inform the analysis.

The paper identified 249 people in secure services and was able to include 136 patients in the analysis. In all, 64 were in NHS provision and 72 in independent sector provision; 109 (80.1 per cent) were male and 27 (19.9 per cent) female; on average, patients were cared for 61.5 miles away from their homes; NHS patients were far closer to home; 69.1 per cent had a mild learning disability; 82.3 per cent had a history of violence; approximately one in six patients could not progress due to a lack of an appropriate ward, facility, resource and/or intervention.

Secure care for this population is a major public health issue. Many are placed a long way from home. Local services should be developed, and there should be sufficiently robust “step down” places for patients to be discharged to.

Systematic identification of the needs of a marginalised group to enable better more appropriate care pathways to be developed in the future.

This paper describes an innovative, multi‐modular group therapy programme based on cognitive‐behavioural principles and psycho‐education. It introduces participants to strategies and skills to assist with deficits such as poor social skills, low self‐esteem, poor emotional regulation and problematic inter‐personal relationships. The manual‐based format of this programme enables members to be introduced to working in a group, and enables facilitators to obtain qualitative information about group members to promote existing skills in future treatment programmes. The core deficit areas targeted by the programme are not by any means exclusive to individuals in in‐patient forensic learning disability settings, so the programme can be useful for clients with learning disability and offending behaviours who are resident in the community.

The forensic nursing role is complex, creates tensions within itself and is underpinned by core values, knowledge, skills and personal attributes; often referred to as ‘good nurse’ characteristics (Smith & Godfrey, 2002). Forensic nurses perform unique, multifaceted roles; they are viewed by patients as ‘a source of treatment, comfort and advice’, but also as ‘part of the system that deprives them of their liberty’ (United Kingdom Central Council for Nursing, Midwifery and Health Visiting & University of Central Lancashire (UKCC & UCLAN), 1999: 42). This is problematic both for nurses and patients. Although appearing as opposites, security and therapeutic characteristics of nurses can and do co‐exist in forensic nursing (Peternelji‐Taylor & Johnson, 1996). Through critical analysis of dialogue from interviews and focus groups, this paper depicts forensic practice with people with a learning disability through a study that explores apparent ‘truths’ about such people detained in forensic settings (here referred to as ‘the men’) and the staff who work with them. Beliefs about nursing characteristics were exposed through discourses present in dialogue between the men and the staff. General research questions included: (1) What are the discourses related to learning disability and forensic practice? (2) What ideologies underpin and justify forensic practice? (3) What in particular are the positive discourses? Related discussion is primarily concerned with the way that staff and men share relationships and with characteristics of the nursing staff. Findings generally suggest that the staff may be viewed as prison wardens, leading to relationships of mistrust. Paradoxically, there are also positive discourses identifying warm and therapeutic relationships and good nurse characteristics of the staff. This may have practice implications, such as enabling staff to hear positive views expressed by the men and begin to develop metrics of ‘good’ forensic nurse characteristics that may positively affect treatment.

The purpose of this paper is to explore the lived experiences of learning disability nurses working within forensic services, and their views on their practice as a speciality.

A qualitative, semi-structured interview-based design was used and participant's voices were examined through interpretive phenomenological analysis.

Nurses explored a range of topics related to their practice and overall, five superordinate themes were developed. Forensic nursing as being both the same and different to generic nursing, the journey, and the emotional challenge of forensic nursing, the balancing act of everyday practice and the role of language within forensic nursing practice.

Very little research has examined the views of learning disability nurses within the forensic field. This study gives both a voice to these nurses and suggests areas of interest both for research and for clinicians to consider in their practice.

The purpose of this paper is to examine the complexities involved in the role of forensic practitioners working with people with learning disabilities and to put forward a preliminary model of forensic practitioner resilience.

This study uses a cross‐sectional qualitative design and samples ten professionals working within a forensic learning disabilities service.

Staff identified a number of complexities in their role which included the presentation of the client group, risk assessment and management, multi‐agency working, and the emotional complexity of the work. A preliminary model of resilience was developed which set out factors that would help staff manage these complexities and work towards meeting the needs of service users. This model includes individual, proximal and wider systemic factors. It is argued that building relationships and establishing trust with service users, staff, and wider agencies is the bedrock of forensic practitioner resilience. Moreover, it is argued that an integrative model of multi‐disciplinary team working helps facilitate trust between staff and is underpinned by trust in the first place.

This paper makes an original contribution because it qualitatively examines how staff within a forensic learning disabilities service interpret their role and details the complexities involved in their jobs. It also puts forward a preliminary model of forensic practitioner resilience.