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For more than a decade there has been a powerful drive towards providing care services to older and disabled people in their own homes. Technology is beginning to provide devices and systems to help do this in a practical way that not only benefits service users and their carers but also has the potential to be very cost‐effective. However, the ethics of telecare will increasingly demand attention. We will also need to address the problems of social isolation likely to be exposed by care systems designed to use electronic assistive technology.

This article introduces the rationale for bringing more closely together those parts of the Home Office and Department of Health that were concerned with policy for health and offenders. The experience of the Prison Health partnership, now entering its fifth year, has demonstrated the enormous potential for improved joint working. Information about the morbidity rates among offenders is included.The paper also introduces three main developmental projects being taken forward across the new organisation: improving the quality of health services for people in police custody (jointly with the Police Leadership and Powers Unit/Home Office), court diversion and care, and improving health and health services for offenders in the community.The projects are described and the challenge noted of bringing together more effectively and efficiently these two large systems.

Research suggests that prison‐based therapeutic communities (TCs) have a positive impact on inmates and recidivism. This study sought to establish the benefits of being in a prison‐based TC rather than a normal wing. A semi‐structured interview was conducted with an inmate on the TC at HMP Wymott in Lancashire and then analysed using thematic analysis.Eight themes emerged, suggesting that TCs are a better environment with better interpersonal relationships, have more help available, are safer, are more structured and hierarchical, have groups and group work, are more challenging, provide confrontational assistance and have various incentive schemes. Such factors brought real benefits to the research participant.Research on the efficacy of TCs is considered, as are the implications of this study's findings for the future of prison‐based TCs. Despite the positive findings, they should nonetheless be cautiously applied.

Low security is a poorly understood concept, particularly in relation to people with an intellectual disability. Characteristics of patients offered an admission to low secure intellectual disability settings have not been robustly demonstrated. The same applies to staff perceptions of low security. The aims of the study were to ascertain the characteristics of patients referred to a low secure intellectual disability unit which lead to an offer of admission, identify the views of staff working on the unit on the concept of low security, and use both sets of data to discuss low secure provision for people with intellectual disability. A case‐controlled study was carried out for 33 patients referred to the unit over 42 months. The characteristics of 18 patients offered an admission were compared with those of 15 patients not offered an admission, and five of the staff working on the unit were interviewed about the concept of low security. Patients offered an admission were more able than those not offered an admission, posed more risks and were more complex diagnostically. Staff working on the unit agreed that their patients were complex, but felt that they were appropriately placed overall. The challenges of low secure provision were discussed by staff. Patients sampled were complex and heterogeneous, but not necessarily ‘forensic’. Their complexity requires sophisticated care plans and management strategies. This study has implications for referrers, staff, patients and managers, and highlights areas for future research.

This paper explores the link between sexual offending and antisocial personality. Drawing on previous research, it illustrates that sex offenders with an antisocial personality are a heterogeneous group, differentiated by several factors. They victimise children, adults or both, those who victimise adults or adults and children are more psychopathic. They are motivated primarily by non‐sexual factors like opportunistic impulsivity or generalised anger, and violence is a source of erotic pleasure in some cases. A small group of men, however, are driven to offend by sadistic sexual fantasies of a serious nature, which develop over time and later form the basis of their violent predatory assaults. Varying definitions of antisocial personality confuse the research, and diagnostic co‐morbidity means that pure psychopathic types are probably rare.

Abstract This article summarises criteria that can lead to a diagnosis of personality disorder before considering the impact on personality disorder of specific interventions and policy initiatives designed to ensure that services respond to need.

Housing‐related support funded by Supporting People has developed in line with traditional service areas relating to criminal justice, health and social care. This means that opportunities for developing integrated services geared to meeting the needs of mentally disordered offenders have been limited. Using a case study to explore service needs, a rethink of commissioning and support roles is recommended for forensic mental health services.