Forensic Learning Disability services are specialist services for people who have a learning disability (LD) and/or have mental health problems who have been arrested, who are on remand or who have been to court and found guilty of a crime (Foundation for People with Learning Disabilities, FPLD, 2012). There are high, medium and low secure units all of which need to be high quality, patient centred and recovery orientated (Joint Commissioning Panel for Mental Health, JCPMH, 2013).
There is a need for forensic health services as the JCPMH (2013) claim that patients in these services have complex needs and these needs typically cannot be met by commissioning generic health services. The time spent in forensic units depends on an individual’s recovery and progress towards rehabilitation. However, although the public protection remains the priority, there is a increasing consensus that forensic inpatient services may not always be an appropriate environment for those with severe mental illness and that detention can exacerbate mental ill health, increase the risk of self-harm and suicide and heighten vulnerability (The Institute Psychiatry, Psychology and Neuroscience, 2015).

The Royal College of Psychiatry (2013) claim that people with a LD who come into contact with specialist learning disability mental health services often have a complex mix of LD, mental illnesses, personality disorders, substance misuse, other developmental and/or physical disorders including epilepsy and possibly present with challenging behaviours. The recent report from the Department of Health (2012a) states that there are a total of 15000 people in England with learning disability or autism who have behaviour that challenges. Commissioners in England (2015) currently claim approximately 7719 inpatient beds in secure mental health services.

NHS England’s quarterly data collections in