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The purpose of this paper is to address and understand recruitment difficulties into psychiatry; however, to date there is no published research with respect to forensic psychiatry. Forensic psychiatry has always been considered to be a popular specialty amongst junior doctors and therefore the recent trend in local unfilled core training (CT) (junior doctor) posts and national reduced competition ratios for higher specialist training has triggered concern. The impact vacant CT posts within the Forensic Service may have on the future workforce must be considered. Further understanding of this trend is required.

A short statement-style survey addressing attitudes and opinions with respect to the field of forensic psychiatry was devised and distributed to all West Midlands core psychiatry trainees who attended post-graduate teaching (November 2014).

Response rate was 64 per cent. In total, 52 per cent of participants expressed an interest in the specialty, but only 13 per cent wished to pursue a career in forensic psychiatry. In total, 68 per cent of responses deemed forensic psychiatry to be a demanding speciality, with over 50 per cent perceiving forensic patients as difficult to work with. There were high rates of uncertain responses with respect to specialty work life. In total, 78 per cent of responses considered experience of the specialty to be useful.

The method chosen to distribute the survey maximised response rate, but may have introduced a Hawthorne effect, as well as response bias, with the visual presence of the researcher. Participants were limited to those who attended teaching on the specified day. This could potentially skew results with an absence of opinions of non-attenders. It may be that characteristics and therefore attitudes and opinions of these two groups are different. A further limitation of the study is that opinions explored are limited to statements included within the survey.

The current views may represent stigma, negative media portrayal and misinformed opinions. Action must be taken to increase understanding, interest and experience. Increased exposure to the specialty needs to occur. This could occur as early as high school, using case-study exercises and career sessions. Teaching sessions, summer school placements and elective opportunities should be made available for medical students. At post-graduate level, taster days as well as earlier access to rotations may be a way forward.

Although entry into Forensic Higher Training remains comparatively competitive, the potential impact of vacant junior doctor (CT) posts within the speciality is concerning. This is likely to negatively influence recruitment into higher training, which may ultimately lead to decreased numbers of qualified forensic psychiatrists. Specialised care for such a risky and challenging patient group could thus be significantly compromised in the near future. Hence, it is vital to understand the current trend in order to act pre-emptively and address the underlying problems. To date no such research has been conducted.

The purpose of this paper is to review the impact of a new, brief forensic rotation for general psychiatry residents on the variety of residents’ forensic exposures.

The authors surveyed residents who trained before and after the implementation of the new rotation to assess the impact of the rotation on the residents’ forensic experiences during training across a variety of domains.

Even in a highly clinical forensic setting, residents participating in the required rotation reported significantly greater variety of forensic experiences than those who had not completed the required rotation, including types of settings and assessments, Rotation completers reported greater exposure to various types of settings and assessments, and courtroom-related experiences, as well as the overall number of forensic exposures. The two groups did not differ in their forensic exposures in general psychiatry settings, civil-forensic evaluations or diverse forensic populations. Secondary analyses showed that increased exposure to court-based experiences and multiple forensic settings was associated with forensic fellowship interest.

This study demonstrates that a brief, mandatory forensic clinical rotation may increase residents’ exposure to forensic settings, assessments and courtroom-related experiences and that increased exposure to courtroom-based experiences in particular may increase interest in forensic fellowship. While not surprising, the results demonstrate that residents were not otherwise having these forensic experiences and that even time-limited forensic rotations can enhance the breadth of residents’ forensic exposures. Further, the rotation achieved these outcomes without using typical forensic sites but instead highly clinical sites, which may be particularly encouraging to residency programs without ready access to classic forensic rotation sites. This study contributes to the small but expanding body of the literature describing the value of increasing psychiatry residents’ training in clinical forensic psychiatry.

A high and possibly increasing prevalence of mental disorders in prisoners has been demonstrated in recent surveys. Psychiatric care of prisoners is subject to wide regional variations in Germany, especially regarding inpatient treatment. Although hospitalized psychiatric patients in prison closely resemble those in forensic psychiatric secure hospitals with regard to socio‐demographic (percentage of women, age peak) and forensic characteristics (delinquency, prison experience), marked discrepancies in the diagnostic spectrum necessitate very different treatment planning based on general clinical psychiatry when considering the approach and especially the treatment duration. In Berlin, we try to develop a care structure within the prison system, which addresses inmate‐specific problems and circumstances as well as the possibility of inpatient and outpatient treatment and semihospitalization according to the principle of “equivalence”.

Down syndrome is one of the common genetic causes of intellectual disability. Adult with Down syndrome may have many psychiatric comorbidities. Therefore, their mental health status should be considered in legal proceedings such as criminal responsibility and legal capacity where they are involved. This study aims to highlight that individuals with Down syndrome are often referred directly to forensic psychiatry without undergoing an interview, despite the fact that this is a group with varied mental statuses.

This study analysed the socio-demographic, clinical and forensic characteristics of eight adult individuals with Down syndrome for whom the Council of Forensic Medicine (CFM) requested an opinion on criminal liability and other legal situations between 2018 and 2022. The CFM is an authoritative institution to which cases from all areas of Türkiye are referred.

The mean age of the individuals with Down syndrome for whom a forensic psychiatric opinion was requested was 24.63 (±7.95) and the mean IQ level was 54.13 (±13.38). All cases were male, 6 / 8 were referred for assessment of criminal responsibility and 4 / 6 of those referred for assessment of criminal responsibility were referred for sexual offences. It was found that 5 / 8 of the cases had moderate intellectual disability and 3 / 8 of the cases had mild intellectual disability.

Regarding the limitations of this study, the first one is the small sample size. Nevertheless, due to the low prevalence of people with Down syndrome in society, it is plausible that their stigmatization may not be reflected in the judicial system, even in cases involving violent behaviour. The second limitation is that the reports lack all psychiatric medical documents, including forensic psychiatric evaluations of individuals with Down syndrome. Additionally, additional diseases were recorded based on familial anamnesis. The third limitation is that this study is the first publication to investigate Down syndrome from a forensic psychiatric perspective. Thus, there is a lack of literature to make direct comparisons and references in the discussion section.

This is the first study about forensic psychiatric aspects for people with Down syndrome. The aim of this study was to examine the forensic psychiatric approach in Down syndrome, one of the most common genetic causes of intellectual disability, the situations in which forensic psychiatric assessment is required and the issues that might be considered important in this regard. Although there are various publications in the literature on the psychiatric conditions of individuals with Down syndrome, to our knowledge, this is the first study to evaluate individuals with Down syndrome in terms of forensic psychiatric evaluation. People with Down syndrome are known to have varying degrees of intellectual disability and different types of psychiatric comorbidity.

People with Down syndrome are a heterogeneous group in terms of intellectual disability. The criminal responsibility and legal capacity of individuals may vary according to the legal situation. When requesting forensic psychiatric evaluation of these patients with psychiatric co-morbidity, patients should not be prejudged in terms of their level of mental competence and each case should be assessed individually.

Training in the prison settings is a mandatory part of higher training in forensic psychiatry. Violence in prisons is a recognised issue, which can impact on trainee safety and overall training experience. The Royal College of Psychiatrists have produced guidelines regarding the safety of the environment in inpatient mental health settings, but there is currently no such guidance regarding the prison setting. The purpose of this paper is to report on a survey of UK-based ST4-6 trainees in forensic psychiatry regarding their training experience in prisons, focusing on supervision and safety.

The authors constructed an electronic survey which comprised of 18 items. This was sent to each UK training programme director in forensic psychiatry, who were asked to distribute the survey to trainees in their region.

There were 36 unique responses, out of an approximate total of 100 trainees. The questions fell into two broad categories: trainee safety and trainee supervision. The main themes that arose were that the majority of trainees (59 per cent) reported that they had not received a formal induction at their prison and had not received training in using the Assessment, Care in Custody and Teamwork framework (58 per cent) and serious incident review protocol (83 per cent). The vast majority (76 per cent) reported not being allocated a personal safety alarm, and 27 per cent reported having received a direct threat from a patient in prison. Responses with regards to consultant supervision were varied. The majority indicated that they received weekly supervision (62 per cent).

The findings indicate that there are a number of areas where both safety and supervision within the prison environment may be improved. This is concerning given the standards outlined by Promoting Excellence (General Medical Council), which highlights the importance of a safe and supported learning environment, and suggests the need for further analysis locally of training opportunities within prisons.

The purpose of this study is to analyse the characteristics of all the referrals to the forensic MHIDD service over the past five years and to compare these characteristics to the cohort of service users attending the three general MHID services based in Dublin which are Service 1, Service 2 and Service 3.

This is a cross-sectional study of adults attending the three generic MHID services and the national forensic MHIDD service. The medical files of service users attending the MHID services were reviewed, and data such as age, gender, level of intellectual disability and psychiatric diagnoses were extracted and compiled into a database. The forensic MHIDD service has since its inception maintained a database of all referrals received and reviewed. The characteristics data needed were extracted from the forensic MHIDD database. All these data were then analysed using the Statistical Package for Social Sciences (SPSS).

The majority of the three MHID service users were in the moderate to profound range of intellectual disability, while the majority of the cases assessed by forensic MHIDD had normal IQ, borderline IQ and mild intellectual disability with 66.1%. The prevalence of neurodevelopmental disorder, schizophrenia and emotionally unstable personality disorder in the forensic MHIDD is comparable to the three MHID services. The prevalence of depression, bipolar affective disorder (BPAD), anxiety disorder and obsessive-compulsive disorder (OCD) is higher in the three MHID services than in the forensic MHIDD service.

The FHMIDD received referrals at a greater level of overall ability, with two-thirds of the service users having mild intellectual disability to normal IQ. The prevalence of neurodevelopmental disorder such as ASD and schizophrenia is comparable between the forensic MHIDD and the three MHID services. There is a higher prevalence of depression, BPAD, anxiety disorder and OCD in the three MHID services as compared to the forensic MHIDD service.

In contemporary forensic mental health and learning disability services effective care and risk management, which is safe for individuals and the public, can only be delivered by drawing upon differing perspectives and interventions. In practice uni‐disciplinary training abounds, but the authors found a lack of formal training inherently constructed to be multidisciplinary. Therefore, a course was developed, in conjunction with a university partner, to meet this need. This modular course is flexible in nature, but is normally delivered over one semester leading to certification. In addition, there is the option of either essay or portfolio submission providing access to credits toward other academic awards. This programme of study, ‘Professional Practice in Secure Environments’ was recently cited as an example of good practice in From Values to Action, the CNO review of mental health nursing (NIMHE, 2006). Modules begin from a foundation of theory and relate it intimately to practice; students develop an understanding of multidisciplinary working by both training together and training in each others' conceptual frameworks. Participants to date include those from health, criminal justice, and social care arenas, and those with no previous higher study have submitted essays. Evaluations are positive and are used to refine delivery and content. The authors conclude that the course demystifies practice and academia, and provides access to both. This is an integral part of the training strategy, which is directed to meeting current and future service needs.Current and future developments and expansion of forensic mental health provision into new types of service will be less effective without a move away from traditional educational approaches. Services to meet the specific needs of groups such as secure long‐stay and personality disorders cannot be sustained effectively without a parallel development of new types of training.The strategic thinking behind this course, practical obstacles encountered, and solutions developed are described in this paper.

The purpose of this paper is to map significant features of the physical design of nine recently planned facilities for forensic psychiatric care in Sweden. The present paper is focused on differences in the physical design, static security adaptations, visions and goals for the projects, economy and steering processes.

In June 2008, records concerning major forensic psychiatric construction projects, planned or carried out between 1970 and 2008, were requested from all 21 regions in Sweden. The documents were collected, organized, critically examined, and analyzed in their contexts. Extensive data have also been retrieved from the internet.

In spite of the common national legislation governing forensic psychiatric care, the projects show great diversity in the physical design and, after 2006, increasing emphasis on static security. The collected material indicates different visions and goals and little coordination between them. It also suggests that the decisions rarely have been preceded by scientific studies or, as it appears, systematic needs assessments. There were also considerable variations in the interpretation of the legislation stipulating public access to official documentation and the time‐frame allowed for such requests.

Limitations of the project especially relate to the incompleteness of the documents received.

This mainly descriptive paper provides an overview of contemporary Swedish forensic psychiatric construction projects, planned for or realized after 2000. This paper points out structural and physical differences between these projects. The systematised documents are made available for research purposes within different disciplines.

Briefly introduces the concept of forensic psychology, looking at areas such as stalking behaviour, self‐mutilation, and execution competency. Suggests that the forensic psychiatrist needs to remain up to date with recent sexual harassment legislation, the use of neuropsychological testing and the assessment of child abuse. Covers other subjects including hate crime on the Internet, and psychological autopsy. Concludes that to uphold the high principles required by law and to withstand scrutiny by defence lawyers, forensic psychology has defined standards by which to judge a persion and studies continue to develop these measures.