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The Forensic Mental Health Services Managed Care Network is described, including the School of Forensic Mental Health. The purpose of this paper is to outline background, it details successes and challenges, focuses on links to clinical practice for Learning Disabilities (LD) service development, describes education and training, multi-disciplinary and multi-agency working and quality improvement. Findings from a small scale brief educational study undertaken in the high-secure service are included as an example of good practice.

Specific features relating to LD are highlighted. Comparisons are made with other managed clinical and managed care networks.

The Forensic Network has evolved over time. It has played a crucial role in shaping Scotland’s approach to Forensic Mental Health and LD. Central to its success is active involvement of key stakeholders, a multi-agency approach and collaborative working practice. Future plans include formal evaluation of impact.

This paper offers an interesting perspective from a forensic mental health managed care network; the existing literature is limited.

Although cultural competence is gaining increased attention among mental health practitioners, such primarily has centered on race, religion, ethnicity, language, and nationality. Thus far, there has been relatively little recognition of specific socialized subcultures aside from the aforementioned groups, and virtually no discussion regarding those associated with various firearm-related subcultures. This topic is particularly relevant to mental health practitioners, as positions on firearm use and ownership frequently split across political party lines, and mental health professionals and academics are more likely to espouse liberal rather than conservative views. It follows that practitioners may understand little about firearms culture and, therefore, are at increased risk for biased decision making when working with clients for whom firearms have relevance. The paper aims to discuss these issues.

This paper takes a conceptual approach to reviewing potential areas of bias in both clinical and clinical-forensic practice in the US context.

The authors detail the prevalence of firearm-related issues in the USA, contextualize firearm-related issues in forensic treatment and evaluation scenarios, delineate a number of firearm subgroups, and recommend considerations for mental health professionals to develop cultural competence as it relates to firearms and associated subcultures.

This is an original conceptual study of cultural competence and various firearm-related subcultures.

Mental health evaluation in criminal cases is a complex and challenging task. The purpose of this paper is to highlight the value of semi‐structured interviews for diagnosis, the use of literature review to increase understanding of a case, and the importance of looking “beyond” the criminal offence itself.

The author conducted a forensic mental health assessment of a man who killed his wife and two young daughters. The case is presented in the order in which information reached the psychologist, so her clinical reasoning becomes apparent. Findings from the police file are integrated with psychological test results and a literature review on familicide and uxoricide.

The case analysis illustrates the perpetrator fits a personality profile found in empirical research on male spousal killers, who often suffer from dependent, avoidant and over‐controlled personality pathology. Four mental health experts who previously reported on this case had not agreed on a diagnosis. Using a more structured approach to assessment, the current analysis sheds new light on the relationship between mental disorder and offence.

The use of semi‐structured interviews for psychiatric diagnosis increases diagnostic reliability. Since there is so much at stake for the assessed in a criminal investigation, the importance of reliability and accuracy of diagnosis cannot be overestimated. Forensic mental health experts serve the court best by integrating findings from structured assessment instruments, file information and empirical research on comparable offender types.

This paper can be useful for teaching purposes and provides guidance to both novice and experienced forensic experts.

A significant number of people held within the secure forensic hospital estate in this country suffer from neuropsychological deficits (e.g. Lowings, 2010; Williams et al., 2010). These deficits, many of them cognitive, have a detrimental impact on patient's abilities to benefit from psycho-educational materials thereby slowing the progress of their rehabilitation. Understanding these difficulties enables interventions to be more effectively targeted and facilitated to the patients’ cognitive strengths. It was against the backdrop of the evidence that a review was commissioned into neuropsychological activity at Rampton Hospital.

The review of the neuropsychological assessment activity was confined to the male patients residing within Mental Health Services (MHS) and the National High Secure Learning Disability Service (NHSLDS) of the hospital. With regards to the MHS, 129 patient files were examined in order to identify the volume of neuropsychological assessment previously undertaken and the make up of the neuropsychological test batteries administered with the current patient group. With regard to the NHSLDS 48 files were similarly examined. In addition, MHS psychologists were surveyed to assess their knowledge of patients within that service who to their knowledge had previously suffered an acquired brain injury (ABI) or had suffered a significant neurological illness likely to have resulted in cognitive impairment.

A scoping exercise identified that a significant amount of neuropsychological assessment was being undertaken, albeit in an unstructured way. This led to a number of patients being subjected to a significant delay before the need for neuropsychological testing and rehabilitation possibilities became apparent. There was a huge variance on when a patient was tested ranging from one month to 14 years and the size of the test battery used, with the number of tests conducted per patient ranging between one single test to 16 tests during a patients stay at the hospital.

Opportunities to more appropriately place patients based upon their abilities could be achieved if the hospital were to adopt a policy of conducting neuropsychological assessments, including cognitive functioning, for all patients upon admission to the hospital. A proportion of patients were known to have had a ABI or a significant illness likely to have resulted in cognitive impairment. This was considered to be an underrepresentation and the taking of a thorough history specifically covering ABI and specific illnesses known to have an impact on cognitive ability and behaviour was also recommended.

In light of this review, services are to take a more systematic approach to assessing neuropsychological difficulties. Consideration is being given to neuropsychological screening becoming part of the admission process.

This paper aims to capture some of the issues raised by those working on the development of mental health services in the prison environment. Each establishment in England and Wales will be different in terms of prison category and prisoner status, but its principle aim will be the same: to follow the strategic plans for the development of mental health services outlined in the National Service Framework. The purpose of the paper is to begin to facilitate and promote further open discussion of the development of services in prisons in order to improve clinical care.

Many people within secure forensic settings are expected to take part in psycho‐educational programmes as part of their treatment and rehabilitation. Many are hampered in their progress due to cognitive difficulties. This paper aims to outline the scale of the problem and to offer potential solutions.

The numbers of people who are placed in secure settings with known neuropsychological difficulties and the range of their cognitive problems are explored. It is proposed that individual education plans based on neuropsychological profiles together with guidance on the preparation and delivery of educational materials could improve the efficacy of psycho‐educational programmes.

Many people within the secure forensic estate have neuropsychological deficits. Many have suffered traumatic or other acquired brain injury or have deficits associated with substance misuse or even childhood emotional trauma. Others have cognitive difficulties specific to their mental health and occasionally their prescribed medication. A significant number will have intellectual disability (IQ<70) or be within the borderline range (IQ between 70 and 79).

Understanding neuropsychological difficulties would mean that best use is made of the psycho‐educational materials presented, thus speeding up and improving the efficacy of the rehabilitation process and potentially reducing the risk that the person poses to themselves and others. There are resources, which offer guidance to teachers of children with neuropsychological difficulties but not for the adolescent and adult forensic population. This paper addresses this gap.

The purpose of this paper was to assess whether the criteria that have been developed by mental health professionals to judge the quality of child custody reports matches the criteria employed by members of the legal profession.

The paper reviews the literature on the standards that have been developed to assess the quality of child custody reports and compare it to the criteria used by attorneys and judges.

The broad criteria used by mental health professionals in assessing the quality of child custody reports mostly matches those employed by judges and attorneys.

There is limited research that focusses on a detailed, qualitative analysis of each component of a child custody report.

Is it essential that a qualitative analysis of child custody reports be performed because it would impact on how professional approach such evaluations.

Having research focussing on a detailed qualitative analysis of child custody evaluations may enhance the quality of such products.

Response style evaluation is a fundamental component of forensic examinations. This retrospective study aims to evaluate how measures of feigning performed with individuals with intellectual disabilities (ID) who were undergoing competency to proceed to trial evaluations.

Using a known-groups design (ID vs non-ID) with 145 individuals, 37 individuals met diagnostic criteria for ID. The individuals were administered the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001), the Inventory Legal Knowledge (ILK; Musick and Otto, 2010), the Evaluation Competency to Stand Trial-Revised, atypical presentation scale (ATP; Rogers et al., 2004b) and the Competence Assessment for Standing Trial-Mental Retardation (Everington and Luckasson, 1992).

The total ILK demonstrated differences between groups with a large effect size (Cohen’s d = 1.02). Six items on the ILK had over a 30% difference as a function of group. However, two revised scales from the ILK, the R-ILK-90 and the R-ILK-95 (Rogers et al., 2017), did not demonstrate differences as a function of group membership with small effect sizes (Cohen’s ds = 0.02 and 0.29). The M-FAST total score and ATP scales were not different between groups, although results demonstrated that individuals with ID would be potentially more at risk to for misclassification as feigning on the M-FAST.

This study has several limitations. It is a retrospective study with a relatively small sample size so additional research is needed to substantiate the results. However, this study highlights the potential for individuals with intellectual disabilities to be disadvantaged when undergoing competency to stand trial evaluations.

This manuscript shows that individuals with ID are at-risk for being mislabeled as feigning when employing standard measures of response style testing if appropriate cautions are not used. However, revised measures that take into account baseline information of legal knowledge offer a way forward that may prevent false positives with individuals with ID.

The mislabeling of individuals with ID could lead to significant problems, including harsh sentences and unnecessary incarcerations. This manuscript provides real-world data and encourages clinicians to be mindful when evaluation individuals with ID for court-ordered evaluations.

This manuscript is critical, as it shows that caution is needed when using instruments of feigning with individuals with ID who are undergoing competency evaluations. This has value for clinicians who are tasked with completing these evaluations for the courts.

The role of evidence-based psychological knowledge in cases of juvenile offending is essential to make appropriate decisions relating to youth who violate legal or social norms, as it carries implications for treatment, intervention and practice. Psychological expert opinions therefore need to meet high formal and methodological requirements while maintaining ethical standards. The purpose of this study is to investigate psychological expert opinions in cases of juvenile misbehavior reported to regional courts in Poland. Juvenile court proceedings concern cases of demoralization and/or delinquent offenses. Demoralization is a legal concept described in the Act of June 9, 2022 on juvenile support and resocialization. This concept was not defined; it was only described through examples of behaviors indicating demoralization. These include the following: violations of the principles of community life; evading compulsory education or schooling; use of alcohol, narcotic drugs, psychotropic substances, their precursors, substitutes or new psychoactive substances; and prostitution.

To reach these goals, court records of juvenile cases in six district courts (N = 253) were gathered and analyzed. A semistructured questionnaire was used to examine the cases in which psychologists were appointed and to analyze the procedures used by these experts for assessing adolescents and their families.

Findings revealed that family judges appoint psychologists both in cases of “demoralization” (i.e. status offenses) and in cases of juvenile delinquency. The opinions were delivered by psychologists who were mostly members of diagnostic teams. Results indicate that such opinions generally comply with the minimal standards recommended by the Ministry of Justice, yet a few problems were observed with the determination of levels of demoralization.

The limitations of diagnostic tools used by psychologists are discussed, and recommendations for future practice are provided.

This study examined the ability of the HCR‐20 Scale (version 2) to predict incidents of in‐patient violence during a stay on a medium secure ward. The study was carried out retrospectively on a sample of 94 admissions, using reports pre‐existing at the time of admission and nursing observations of behaviour in the two weeks that followed admission. The sample group was made up of mentally disordered offenders and patients with challenging behaviour. Their episodes of care averaged two years.The H and C scores, singly or combined, did not show powerful predictive capacity for the sample as a whole, which had a high base rate for violence. Insufficient variance and poor inter‐rater reliability precluded use of the R variable. For purposes of analysis, violent patients were also grouped on the number of incidents committed during their episode of care. Here the C Scale items showed strong predictive capacity for patients with more than 10 incidents during their stay. The paper argues that the latter finding supports a method of predicting admissions at risk of frequent incidents of violence.