The clinical profile and service needs of psychiatric inpatients with intellectual disabilities and forensic involvement

There is increasing recognition around the world that individuals with intellectual disabilities (ID) and mental health issues with forensic involvement are a particularly complex patient group whose needs are not well met. However, few studies have examined how these individuals may differ from other service users within a psychiatric hospital setting. Inpatients with ID and forensic involvement were compared to non-forensic inpatients with ID and to forensic inpatients without ID in terms of psychiatric diagnoses and clinical issues. Inpatients with ID and forensic involvement were younger, more often male, had greater lengths of stay, were more likely to have a personality disorder diagnosis and less likely to have a mood disorder diagnosis than their counterparts with ID. They were also similar to their forensic counterparts without ID with regards to demographics, but were less likely to have a substance abuse or psychotic disorder diagnosis. Furthermore, patients with ID and forensic involvement exhibit more severe symptoms, have fewer resources, and a higher recommended level of care than other forensic patients. Patients with ID and forensic involvement present with unique demographic and clinical profiles. The characteristics that set these individuals apart from other services users should be taken into account in order to better meet the needs of this complex group.