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Secure settings: what makes for a good outcome when people move on from inpatient provision?

Study finds need to establish specialist forensic support teams to ensure best possible outcomes for offenders who have behaviours that challenge

Study finds need to establish specialist forensic support teams to ensure best possible outcomes for offenders who have behaviours that challenge


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There is a strong policy desire to move away from reliance on inpatient services to meet the needs of people with learning disabilities who have challenging needs or associated mental health problems.

This includes people in secure services for those who have committed criminal offences. For many learning disability nurses this means adapting, changing and embracing new ways of working.

A paper examined the characteristics and outcomes of 40 adult males, with a range of offending profiles, admitted and discharged from a secure hospital in London between 2009-2016. As well as their learning disability, 17.5% of people also had autism, 35% had a psychotic disorder and 35% had been diagnosed with a personality disorder.

Reoffended

The study reported that about one fifth of people reoffended during the study period and a similar proportion were readmitted to some form of inpatient provision.

Of these about half had been solely supported by community learning disability teams, while smaller numbers were supported either by specialist community forensic teams, general community mental health teams or through a shared approach involving several teams.

The authors suggest, given the clinical complexities and need for ongoing skilled risk management, that there is a need to establish increasingly specialist community forensic support teams to ensure the best possible outcomes for people leaving secure settings.


Wooster L, McCarthy J, Chaplin E (2018) Outcomes of an inner city forensic intellectual disability service. Journal of Intellectual Disabilities and Offending Behaviour. 9, 1, 1-8.


Dave Atkinson is an independent consultant nurse

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