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Continuity of forensic mental health care is important in building protective structures around a patient and has been shown to decrease risks of relapse. Realising continuity can be complicated due to restrictions from finances or legislation and difficulties in collaboration between settings. In the Netherlands, several programs have been developed to improve continuity of forensic care. It is unknown whether professionals and clients are sufficiently aware of these programs. The paper aims to discuss this issue.

The experienced difficulties and needs of professionals and patients regarding continuity of forensic care were explored by means of an online survey and focus groups. The survey was completed by 318 professionals. Two focus groups with professionals (15 participants), one focus group and one interview with patients (six participants) were conducted.

The overall majority (85.6 percent) reported to experience problems in continuity on a frequent basis. The three main problems are: first, limited capacity for discharge from inpatient to outpatient or sheltered living; second, collaboration between forensic and regular mental health care; and, third, limited capacity for long-term inpatient care. Only a quarter of the participants knew the existing programs. Actual implementation of these programs was even lower (3.9 percent). The top three of professionals’ needs are: better collaboration; higher capacity; more knowledge about rules and regulation. Participants of the focus groups emphasized the importance of transparent communication, timely discharge planning and education.

Gathering best practices about regional collaboration networks and developing a blueprint based on the best practices could be helpful in improving collaboration between setting in the forensic field. In addition, more use of systematic discharge planning is needed to improve continuity in forensic mental health care. It is important to communicate in an honest, transparent way to clients about their forensic mental health trajectories, even if there are setbacks or delays. More emphasis needs to be placed on communicating and implementing policy programs in daily practice and more education about legislation is needed Structured evaluations of programs aiming to improve continuity of forensic mental health care are highly needed.

Policy programs hardly reach professionals. Professionals see improvements in collaboration as top priority. Patients emphasize the human approach and transparent communication.

Forensic mental health care is a unique field that poses complex demands on professionals. Forensic vigilance is a hypothesized specialty of forensic mental health professionals, allowing them to meet the complex demands of working in forensic settings. Forensic vigilance consists of theoretical and experiential knowledge of mental disorders, theory of offending behavior, the criminal history of patients and environmental observations and clinical judgment. Although this concept has only been recently described and defined, it is still unknown which professional and individual factors are related to forensic vigilance, and if forensic vigilance is related to job stress and burnout symptoms. The purpose of this study was to investigate the relation between forensic vigilance and several professional and individual factors.

The current study investigated whether forensic vigilance is predicted by years of work experience and the Big Five personality traits by means of an online survey among forensic mental health professionals and whether forensic vigilance is associated with work-related stress, burnout and workplace satisfaction.

The 283 forensic mental health professionals who responded to the survey indicated that forensic work experience, but not general experience, positively predicted forensic vigilance. Forensic vigilance was negatively associated with Neuroticism and positively associated with Openness to experience and Conscientiousness. Forensic vigilance did not predict work-related stress, burnout symptoms and workplace satisfaction. Personal accomplishment was positively related to forensic vigilance.

Findings of the present study increase the understanding of the construct of forensic vigilance. The findings presented here highlight the importance of differences between professionals in terms of experience and personality. Training programs should capitalize on experience, while taking personality differences in consideration. Personality differences are relevant in hiring policies and team composition. Finally, to reduce workplace-related stress and burnout symptoms, institutions should consider known factors that influence work-related symptoms (e.g. experienced autonomy) rather than forensic vigilance.

To the best of the authors’ knowledge, this study represents the first effort to study forensic vigilance in relation to personality, work experience and experienced workplace-related stress and satisfaction.

Various attempts have been made to understand and resolve the enduring lack of cohesiveness of multidisciplinary teams (MDTs), their dysfunctional service delivery and the feelings of distress among some of the professionals who work in them. Distortions in forensic MDTs have sometimes compromised service delivery and effective risk management. Several public inquiries relating to high‐profile incidents in forensic mental health have noted the role of dysfunctional MDTs. This paper describes the philosophy, structure, functions and achievements of a forensic community MDT in Wellington, New Zealand. It explains a model of care that is adaptable, comprehensive, effective and evidence‐based. It highlights the role of the extended MDT and embedded cultural units from which care professionals work together, share a common philosophy of care and tailor their care to the needs of the individuals or populations they serve.

The Central Mental Hospital in Ireland is one of the oldest forensic mental health units in Europe. The hospital is currently in the process of transforming from a single inpatient site to a modern national forensic mental health service. Central to this transformation is the need to move from the traditional security‐focused model of care to a model of recovery. The challenge incumbent within this transformation is to incorporate a sophisticated amalgamation of the patients' needs while recognising the broad range of security requirements in a forensic setting. This paper considered that adopting an integrated care pathway (ICP) approach would provide the service with a vehicle to re‐engineer our principles and systems of care. Likewise we hypothesised that the ICP would enable us to consolidate best practices such as multi‐ disciplinary working, structured professional judgement and the involvement of the patient and their carers. Thus far it has afforded us the opportunity to examine many aspects of the care delivered within the service. It has provided a shared understanding of key standards among clinicians, service users and carers that are necessary to implement a quality care pathway. It has certainly not been a stagnant process, and the initial work often bears no resemblance to the current process. In turn, we expect that it will continue to change as the path travelled is as important as the outcome and the ICP becomes a dynamic part of the organisation.

Forensic mental health programs (FMHPs) in Ontario, Canada provide rehabilitation and supervision services. However, models available to guide their delivery are primarily adapted from fields outside of forensic mental health. To partially fill this gap, this paper aims to provide a general review of the process a multi-professional team took to develop the Integrated Forensic Program [IFP]-Ottawa Model of Risk Management & Recovery.

Working groups were initiated to identify the needs of patients in their local setting, conduct a literature review on care delivery models in forensic mental health and build a service delivery model specific to forensic mental health.

The resulting model places patient engagement at its centre and encompasses eight domains of need that contribute towards the patient’s recovery and the management of the safety risk they pose to the public, namely, the basic needs, diversity and spirituality, social, occupational, psychological, substance use, physical health and mental health domains.

The IFP-Ottawa Model of Risk Management & Recovery provides a framework to which therapeutic group services for persons in FMHPs can be aligned.

The leadership teams in FMHPs could use this framework and the method used for its development to ensure group services provided at their FMHPs are evidence-informed and coincide with their patients’ specific needs.

Examining the education and training needs of forensic nurses is paramount as services move from the older institutions to new care settings. The purpose of this study was to identify Irish Forensic nurses perceived deficits in their knowledge and skills to assist them to provide effective seamless care for individuals with an intellectual disability within their forensic mental health service, so that appropriate training could be provided.

Training needs analysis (TNA) procedures are used as a way of establishing the continuing processional development of staff, as they seek to identify the gaps between the knowledge and skills of an individual and the need for further training. A training needs tool developed by Hicks and Hennessy (2011) was used and completed by nurses working in an Irish forensic mental health service. A total of 140 surveys were circulated and 74 were completed (51 per cent response).

The top priority training needs identified were for additional training in research and audit and in the use of technology. Other self-identified training needs included additional training in behavioural management for challenging behaviour, understanding mental health and intellectual disability and dual diagnosis, training in enhancing communication skills and how to work with patients who have an intellectual disability patients specific training on autistic spectrum disorders and a guide and template for advance individual care planning and for caring for the physical health needs and promoting the physical health needs of these patients.

Despite there being a vast range of training issues identified, the majority of nurses appear to have a clear idea of their training needs to ensure the provision of seamless care for individuals with an intellectual disability within a forensic mental health setting. This TNA has identified the specific needs of nursing staff working at different positions across the interface of intellectual disability and forensic mental health care.

With permission, this paper is an edited and abridged version of an article written by Richards, Doyle and Cook for The British Journal of Forensic Practice (Richards et al, 2009), detailing their literature review on family interventions in dual diagnosis and with reference to forensic mental health care. There appeared to be limited direct evidence, therefore various domains were examined and extrapolated to a forensic setting as appropriate. The review indicates the potential for positive outcomes for families following family interventions in dual diagnosis, which may be beneficial in a forensic setting in lowering risk.

Service users’ voice is at the forefront of movements within psychiatry that look to create more humanising care. Although genuine co-production of knowledge is limited by the power differential intrinsically functional to the health care setting, the arts have the potential to create collaborative environments and equalise relationships. The purpose of this case study is to describe and discuss the design and pilot evaluation of creative writing workshops in a forensic mental health ward as an innovative method for humanising care.

A creative writing intervention focussing on everyday experiences was implemented in a forensic mental health ward and involved four residents and four mental health professionals working together. Interviews were conducted with the four mental health professionals as part of a service evaluation. Transcripts were analysed using thematic analysis.

Two themes emerged from the analysis of interviews with mental health professionals: “a new way of learning about each other” and “imagining beyond the staff-resident relationship”. The authors discuss the intervention’s benefits in terms of its potential to foster mutuality and empathy beyond the illness narrative.

Creative writing can be used to engage patients and mental health professionals to jointly share everyday experiences and identities beyond illness.

The creative writing workshops present an innovative approach concerning the use of creative arts for humanising care through mutuality.

The nature and problems of forensic nursing research are presented and discussed. The background to and current state of forensic nursing research are described. Some differences between the nature of forensic psychiatric, psychological and forensic nursing research are identified. Forensic psychiatric research deals primarily with drug treatments and psychological research deals with specific therapies often referred to as ‘talking therapies’, whereas forensic psychiatric nursing research deals with care of the patient and all that entails, such as physical, psychological, emotional, spiritual and social care. Issues identified include the power gradient and forensic nurses' position on that gradient, the application of Lee's typology of research as threat and Mason's (2003) discussion of the typology in the forensic context. The article concludes with some discussion of the strategic direction required for further development.

South America is a heterogeneous continent, with diverse prison realities. Its prison population is estimated at 600,000 inmates, of whom 10,000 are declared insane. Physical and mental health care supplied to the inmates is precarious and preventive programs in progress are rare. The authors’ comment on the Roman Law tradition and describe the situation in Brazil and Argentina, from the point of view of their legal backgrounds. They also consider the kind of mental health resources found and the types of treatment offered, mainly in Forensic Psychiatric Hospitals. Their conclusion emphasizes the need to improve the conditions of penitentiaries in South America, which, because of their deficiencies, often violate the human rights of prisoners.