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Legislative guidance stipulates that people with a learning disability have the right to receive local provision of personalised support within the least restrictive environment. On these bases there is a growing emphasis on the requirement for local authorities to develop appropriate services for people who are currently in a hospital setting. The purpose of this paper is to examine the literature addressing factors influencing the provision of effective community-based forensic services.

The six articles were analysed separately using the evaluation tool – Currency, Relevance, Authority, Accuracy, Purpose. The six articles used divergent sample groups and employed both qualitative and quantitative methods to collate data. The articles shared a purpose of examining forensic community service provision with an aim to improve services.

There were three themes that emerged consistently across the literature these included: balancing risk management vs individual autonomy; multi-disciplinary and multi-agency working; service improvement. There is a growing emphasis on the need to replace long-term hospital placements with specialist, community provision, employing least restrictive methods and positive responses to crisis situations. In this climate, it is crucial that multi-disciplinary agencies from local authority, health and the charitable and private sector continue to work collaboratively on the integration of service provision in order to bring about the development of effective and responsive community services.

Research limited to peer reviewed and published research papers focusing on the subject of community forensic services with publications specifically made within the time frame of the Transforming Care Agenda.

This paper looks to examine the practical solutions to providing effective community forensic services for a person with an intellectual disability and makes recommendations for research into improving service specific training for support staff.

Following the Winterbourne View Hospital scandal (BBC One, 2011) instigations were made to make legislative change under the Transforming Care Agenda. Despite a renewed conviction in the rights of people to be a part of their local community without segregation or discrimination, professionals in the field continue to report a failure to reduce numbers of people in long stay hospitals and secure settings. With commissioning under pressure to make these intentions a reality it is a really good time to reflect on practice and evaluate service models to establish the factors that bring about positive outcomes for individuals enabling inclusion within community settings.

This review will focus on the literature evidencing positive intervention and outcome focussed methods of supporting people with a forensic history in the community. This is an entirely original piece of work analysing peer reviewed and published research.

It is now widely acknowledged that stress negatively impacts holistic and well-being and has been identified as a major global concern. The purpose of this paper is to report on a qualitative research study which sought to explore the experiences of stress and the use of coping strategies from the perspective of people with intellectual disabilities (ID) currently residing within the forensic in-patient services of one National Health Service Trust.

Data were gathered via focus group discussions involving 20 service-users with an ID. The data were subject to thematic analysis.

Data analysis produced three key themes: experiencing stress; sources of stress and coping with stress.

The findings of the research study have implications for practice. These include the need to utilise appropriate stress assessment measures and implement effective stress reduction and management programmes to address the holistic needs of people with ID, to ensure forensic services are truly high quality, person-centred and recovery focused.

Whilst stress experienced by people with ID residing in community settings has been explored, no studies have focused on how stress is experienced by people with ID residing in forensic services. This paper seeks to address this gap in the literature.

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.

The purpose of this paper is to demonstrate the implementation of modern technology by using a web camera to facilitate a family intervention (e‐FI) in the treatment of schizophrenia, within a forensic service.

A case study using questionnaire tools to measure outcome variables from the web‐based family intervention was used. Pre‐, mid‐ and post‐treatment scores were compared to present the progression of outcomes throughout the study.

This study provides an account of the successful implementation of a web camera facilitated family intervention in a forensic service. The findings showed improved social, emotional and practical outcomes for the family involved. The ease and acceptability of using the technique is demonstrated.

This study presents a novel application in utilising a web camera to implement family intervention within forensic services with successful outcomes.

Several studies have related diagnostic information and adversity in childhood to criminal careers and risk of recidivism. Notably, ADHD and conduct disorder in childhood, schizophrenia, sexual abuse and physical abuse have been associated with offences in adulthood. This study investigates these variables in relation to large cohorts of offenders with learning disabilities. A case note review was undertaken for 126 individuals referred but not accepted into forensic learning disability services and 197 individuals accepted for such services. Results are reported on diagnostic information and experience of adversity in childhood. ADHD/conduct disorder featured prominently in both groups. Autistic spectrum disorders were not particularly over‐represented. For adversity in childhood, general socioeconomic deprivation featured prominently in both groups. This also increased significantly for those accepted into services. Sexual abuse and non‐accidental injury were featured at around 13‐20% for both groups. These results are broadly consistent with the mainstream literature on offending, ADHD/conduct disorder and general deprivation featuring significantly in all groups and rising for those accepted into offender services. It is important to deal with these aspects during assessment and to provide appropriate psychotherapeutic services for these individuals.

The purpose of this paper is to provide a professional consensus position with regard to the provision of specialist inpatient rehabilitation services for people with intellectual disability (ID), autism and mental health, behavioural or forensic needs in the UK.

The concept of rehabilitation is discussed, as well as the functions and goals of specialist inpatient rehabilitation services with regard to the aforementioned contexts. Current use of rehabilitation beds is considered, both on a regional and national scale, as well as various outcome measures, including effectiveness, patient safety and patient experience.

There is a clear need for specialist inpatient rehabilitation services, though historically there have been instances of inappropriate admissions, as well as lengthy inpatient stays that could have been significantly reduced with the right type of community support package. Such services should be subjected to rigorous measurement of outcome measures, to determine that patients within such services are receiving a consistently high standard of care. Additionally, amendments to current legal frameworks should be considered, with a view to accommodating for individuals with capacity who require continuous community-based supervision.

To the best of the author’s knowledge, this is the first article detailing a professional consensus position for specialist inpatient rehabilitation services for people with ID, autism and mental health, behavioural or forensic needs.

Managing the risk posed by violent and sexual offenders who have a personality disorder is a key priority in forensic mental health services. An important element of service delivery is to maintain client engagement with the care team in order to promote positive change. Service‐user involvement in multi‐method evaluations has been shown to increase involvement and ownership of services and thereby increase engagement. This study presents the findings from a qualitative service user evaluation of a pilot project known as the Forensic Intensive Psychological Treatment Service (FIPTS). The main findings highlight the importance of a good therapeutic relationship and good communication with the care team, how therapy work offers insight and understanding into behaviour, encouraging service users to make positive changes, and how returning to work gives hope, independence and confidence. Service users generally feel supported and able to approach the team with any concerns of escalating risk and also highlight certain areas of improvement.

In 2008 a dual diagnosis service was set up within the forensic services of East London NHS Foundation Trust. This paper provides an outline of the service as it currently stands, and a description of the multidisciplinary staff roles within the service. Each staff member reflects on the success and challenges over the year that the service has been operational. Pointers to our future plans and strategy development are made.

Peer support workers (PSWs) are individuals with lived experience of mental health difficulties, who apply this to support and inspire others in their recovery. The role of PSWs is relatively new within the forensic health-care service. Although there has been little time for these roles to develop, PSWs have successfully integrated into community teams. Despite perceived benefits of having these workers within a multi-disciplinary team (MDT), the views held by mental health professionals in forensic services have not yet been studied. The purpose of this research is to develop an understanding of the experiences of staff working with PSWs in a community forensic team and the impact this has on them.

Structured, individual interviews were conducted with eight mental health professionals, from a variety of disciplines, used across two community teams within forensic services. The data was examined according to thematic analysis.

The data indicated general positive attitudes held by professionals surrounding the working with PSWs, including the themes “providing alternative perspectives”, “unique relationships” and “hope”. Yet, themes concerned around “role ambiguity”, “boundaries” and “the impact on PSWs” also arose.

This study provides insight into the attitudes held by members of an MDT of working with PSWs. Although seemingly positive, the lack of clarity around the role of the PSW is problematic.

To the best of the authors’ knowledge, this is the first study to explore the employment of PSWs in the context of UK forensic settings, highlighting the benefits and challenges of such from the perspective of staff.

This paper aims to capture the views of forensic mental health service users; focusing on how services promote the aspiration to work, the development of skills for work, and the vocational rehabilitation process. It seeks to provide insight into forensic mental health service users' views on the barriers and enablers to accessing work together with suggestions for enhancing practice, and implications for further research.

Ten participants from a range of forensic mental health services throughout Scotland took part in semi‐structured interviews. Participants were involved in either paid work, voluntary work or work preparation. Interpretative phenomenological analysis (IPA) allowed exploration of an individual's lived experiences and how they make sense of this.

Service users valued the opportunity to address vocational issues at the earliest opportunity in their rehabilitation. Work had an overwhelmingly positive impact on mental health. Analysis of interview transcripts revealed three master themes: “Normalising my life”: the positive impact of work; “Gradual steps”: facing barriers; and “Practical help and encouragement”: feeling supported. There is much to gain from good multidisciplinary rehabilitation within secure hospitals and the community, with work playing an important role in recovery and symptom control. Forensic services should focus on employment and the aspiration to work early, demonstrating awareness that attitude and the aspiration to work are a much more reliable indicator of success than diagnosis and mental health symptoms.

Few qualitative studies have investigated service users' views of work within forensic mental health, yet such information can be crucial to enhance and improve service delivery.