Community forensic mental health services in England: mapping provision, structure and function

AIMS AND METHOD: Community forensic mental health services (CFMHS) in England were developed to reduce reliance on hospital care for this population, but provision varies. It is unclear whether standard setting work has increased consistency. Freedom of information requests were therefore sent to 50 National Health Service Trusts in England, to examine the population, staffing, treatment provision and organisation of CFMHS. RESULTS: Data were provided for 32 CFMHS, of which 59% were part of secure hospital-based services and 41% were standalone services working in parallel with general services. There was variation in aspects including professional composition, functions, the settings from where CFMHS accept referrals and long-term approach to patients subject to special restrictions under the Mental Health Act 1983. CLINICAL IMPLICATIONS: CFMHS continue to vary, especially in their interface with services other than forensic hospitals. This may impede standard setting and empirical evaluation. Different approaches to centralising oversight may be needed for standardisation.