Services for mentally disordered offenders in community psychiatry teams

Community teams in Wessex were surveyed to determine their capacity to supp ort mentally disordered offenders (MDOs) in the community. All teams experi enced difficulties in supporting MDOs. Proficiency levels of key workers di d not match the demands of this group. Furthermore, the compartmentalized n ature of services led to appropriate expertise being denied to MDOs. Learni ng disability teams had problems of discriminating between health and socia l care. They had the highest levels of MDOs on their case-loads and their c lients posed the greatest challenge in terms of violence, self-harm and sex ual offences. Drugs and alcohol were highly implicated in the behaviour of all client groups except those with learning disabilities. The number of cl ients subject to 'formal' psychiatric supervision was low, and day services and suitable accommodation were common service deficiencies. Services shou ld adopt a more co-operative style of working with improved communication b etween secure institutions and community teams. Additionally, community tea ms could be supplemented and supported by district forensic community teams , to maintain MDOs in mainstream services.