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Forensic mental health services play an important role in providing treatment and accommodation for people diverted from prison or the courts who require secure and specialist mental health treatment. There are more than 3,500 people in medium and high‐secure hospitals who have been directed there by the courts or prison system, and nearly 1,000 new admissions are received each year. Yet, the facts and figures relating to these services are patchy and not widely published. This paper builds on an earlier statistical briefing produced by the Sainsbury Centre for Mental Health in 2007, and seeks to provide an up‐to‐date and improved understanding of this area of service provision by presenting the most recent data and figures.

There is a general consensus that healthcare for people with intellectual disabilities should be provided by multi-disciplinary teams. Within a forensic setting, recommendations are often made for separate or “parallel” forensic teams, operating independently of generic mental health or intellectual disability teams. An alternative to this model is an “integrated” service, where specialist forensic clinicians work within the general intellectual disability service, to provide support for clients with forensic needs. For clients with intellectual disabilities and forensic needs, there may be advantages to providing access to a wider multi-disciplinary team, through the application of an integrated model. The purpose of this paper is to illustrate the working of an integrated forensic service within a learning disability team, to identify positive aspects of this model, and how potential shortcomings may be overcome.

Literature review, description of service outline with case example.

Although some studies have compared parallel and integrated forensic models within mental health services, there are no evaluations that compare models of forensic services for individuals with intellectual disabilities. However, specific advantages of an integrated model may include availability of multi-disciplinary clinicians, development of forensic skills across wider groups of clinicians, reduction in stigma and avoidance of delay in transfer of care between services. In addition, in areas with smaller populations, parallel services may not be feasible due to low case numbers.

There has been no formal evaluation of parallel vs integrated forensic services within an intellectual disability setting. However, the authors describe a fully integrated service and suggest means by which the potential shortcomings of an integrated model may be overcome.

The aim of the study is to identify the latest trends in accounting forensic work in Australia by examining how accounting firms that specialise in forensic services meet the needs of their clients, and to inform universities on the appropriate curricula to ensure the knowledge and skills of future graduates meet industry expectations.

The methodological approach taken in this study was exploratory, and qualitative semi‐structured interviews were the primary data collection instrument used.

Findings from 32 interviews with Australian practising forensic professionals suggest that these services are broad and complex. Opinions differ widely on the best way forward for this area of the accounting profession. Both work‐based and personal attributes required by practising forensic professionals together with the wide range of complex services offered in Australia are presented in a posited model, providing a unique contribution to international forensic accounting literature. Forensic services firms require strong work‐based skills such as oral and written communication skills, technology and analytical skills, in addition to an accounting qualification, as part of their under‐graduate or post‐graduate degrees.

Perceptions were also that graduates require strong interpersonal skills, enthusiasm, intelligence and the ability to work independently and although this has been reported in the literature previously, findings from this study suggest there is still a deficiency in forensic accounting graduates skill set, particularly in relation to oral and written communication. The lack of an Australian‐based forensic accounting certification was also raised.

Both work‐based skills and personal attributes are presented in a posited model of the Australian forensic accountant, providing a unique contribution to international forensic accounting literature.

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.

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.

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.

This paper reports on the first eight years of a community‐based forensic team for people with learning disabilities. The authors give an overview of current research and government guidance regarding the prevalence, care pathway and treatment of people with learning disabilities who offend. The role and function of the community forensic team is described and an analysis of referrals to the service is given. The authors reflect on the frustrations as well as the achievements associated with providing this service.

Physical health inequalities and mortality rates are higher amongst individuals with severe mental illness (SMI), including among forensic populations, than the general population. This paper aims to explore the experiences of individuals accessing primary health care following discharge from secure services, and the practitioners who support them.

Face-to-face qualitative interviews were conducted with service users (n = 4) and mental health practitioners (n = 4) within a forensic community mental health team in one NHS Trust in England in 2019. Data were analysed using the Interpretative Phenomenological Analysis.

Four super-ordinate themes emerged: perceived importance of physical health, agency, responsibility and relationships. Service users mostly saw themselves as passive recipients of health care and prioritised their mental health over their physical health. Close working relationships meant that mental health practitioners were often the first contact for service users with any health issue and thus felt a sense of responsibility for their physical health care. Service users who did access primary care reported that consistency of professional, feeling understood and listened to without judgement or stigma were important.

Interventions for service users that include practicalities and strategies to facilitate independence in physical health care, and collaborative working between primary care and forensic mental health services, are encouraged.

This study highlights some of the unique challenges in forensics around improving physical health outcomes for individuals with SMI.

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.

This study examines the implementation of the recovery model or ‘philosophy’ in a secure NHS forensic service. Twenty‐six (86.7%) staff and seventeen (70.8%) mentally disordered offenders (MDOs) were interviewed in Spring 2009 from the rehabilitation and pre‐discharges units in a medium secure forensic service in Kent, UK. Their views on recovery were measured using the Developing Recovery Enhancing Environments Measure (DREEM: Ridgeway & Press, 2001). Staff consistently rated all 24 elements of recovery as more important than the MDOs. Staff also rated the elements of recovery as better implemented, except Intimacy and Sexuality. There was a significant effect of MDOs' forensic history (restriction status and index offence type) on ratings of how well elements of recovery were implemented. Staff and MDOs rated all elements of recovery as at least moderately important (above median value). The implications of the recovery philosophy in forensic mental health services are discussed.