Patterns of risk and need in an NHS community-based forensic learning disability and autism service

Purpose An up-to-date understanding of the needs and risks of adults with learning disabilities and/or autism (LDs/A) who present with forensic needs is essential to ensure policies, research and interventions are well informed. The purpose of this study is to systematically analyse demographic, clinical, forensic and service provision data from referrals to a single community-based forensic LD and autism service. Design/methodology/approach Retrospective case reviews were conducted using a standardised form and procedure. Referrals to the service over a three-year period (July 2022–July 2025) were included, and demographic, clinical and forensic data were collected. Two, 18-month review periods were created (Periods 1 and 2). Chi-square tests for independence were used to explore differences between review periods. Findings In all, 219 referrals were received and 162 progressed to initial assessment (Period 1 = 80; Period 2 = 82). Most of the sample were male (90.1%), White (74.1%) and under age of 34 years (69.1%). Mild LD was most common (24.7%). General interpersonal violence (45.1%) and sexual offending (48.1%) were the most prevalent current risk types. Social care and LD services were the biggest referring agencies. Consultation and direct intervention were the most used pathways. Non-significant trends across time were explored, along with implications for the service, research and wider practice. Originality/value This study presents the biggest retrospective review of community-based forensic LD/A risks, needs and service provision in over a decade. Trends in forensic risks, clinical needs and service provision across time are analysed to explore the dynamic nature of this population.