Purpose This study aims to address the lack of emphasis within forensic mental health assessment (FMHA) on formal appraisal of race- and ethnicity-related experiences, despite their profound impact on minoritized groups. It provides theoretical and ethical justification for integrating explicit appraisal of race and ethnicity into FMHA. Design/methodology/approach The study conducted a scoping review of 108 existing race- and ethnicity-focused (REF) psychological measures to identify those that are psychometrically sound (i.e. reliable, valid), recent and sufficiently documented for potential use in forensic contexts. Measures were evaluated against these criteria and narrowed down to a final set of 16. Findings Only one measure, the UConn racial/ethnic stress and trauma survey, was deemed currently appropriate for use in FMHA without revision. The remaining 15 require further development or adaptation to meet the standards for forensic application. The study outlines considerations for revising these tools for such use. Research limitations/implications The authors view this publication as a starting point for the further empirical work that will be required to validate revised or newly developed measures for forensic use and to understand how these assessments may influence FMHA outcomes. Social implications Formal inclusion of race and ethnicity appraisals in FMHA may reduce bias, enhance fairness and improve the relevance of forensic evaluations for minoritized individuals. Originality/value To the best of the authors’ knowledge, this is the first study to systematically evaluate race- and ethnicity-related psychological measures for their applicability in FMHA, filling a critical gap in the literature and advancing the discussion of equity and cultural competence in forensic practice.

PurposeThe purpose of this paper is to provide insight into the experiences of individuals with a criminal history of participating in a community life skills and work-readiness programme.Design/methodology/approachSemi-structured interviews were conducted with seven individuals that have a criminal history who were participating, or had previously participated, in a community life skills and work-readiness programme. This data was analysed by interpretative phenomenological analysis.FindingsFour superordinate themes emerged, these were: “need to change”, “changing identity”, “giving back to the community” and “a sense of belonging”. These themes are discussed in relation to desistance literature and the Good Lives Model.Practical implicationsThis research identifies through the participants’ narratives that engaging with the programme appeared to facilitate the desistance process. The importance of community programmes that provide participants skills and social integration must be acknowledged.Originality/valueThere is limited research on the experiences of forensic services users’ experiences of community programmes, especially those that are not aimed specifically at ex-offenders. The results of this research can be used to enhance services and identify further research areas.

PurposeThis research paper reports findings from a qualitative analysis which explored pornography use in secure hospitals. The purpose of this paper is to investigate what attitudes staff working in secure hospital have towards patients having access to pornography, how they make decisions regarding access to pornography and what factors they take into account during this process. This research is an extension of a prior quantitative research study (Mellor and Duff, 2019).Design/methodology/approachThe study utilised a qualitative approach using semi-structured interviews to explore professionals’ attitudes towards pornography use in a secure hospital. The sample comprised of six volunteers who had taken part in a previous research study (Mellor and Duff, 2019) requesting to discuss the topic area further. As such this research study was developed. Thematic analysis (Braun and Clarke, 2006) was used to analyse the qualitative data and the Attitudes towards Pornography Scale (Evans-DeCicco and Cowan, 2001) was used to collect demographic information.FindingsSix themes were identified from the transcripts. The first theme explores staff members’ attitudes towards pornography. The second relates to the use of boundaries and monitoring of pornography. The third theme looks at the potential impact that pornography could have on the patient, either positive or negative. The fourth theme explores the extent to which patients are still considered as human beings, whereas the fifth theme explores the vulnerabilities that may make patients more at risk of being negatively influenced by pornography. The final theme looks at decision making regarding access to pornography.Practical implicationsThe research offers an insight into how pornography within secure hospitals is managed. The research also provides an exploration into multi-disciplinary team decision making with regard to pornographic material and notes the general openness of staff towards patients having access to pornography.Originality/valueThe findings have important messages for services with regard to policy making. The findings are also relevant for understanding how pornography is managed with in secure hospitals.

PurposeThe adaptationist approach of evolutionary psychology provides a model of substantial scope for understanding the function of human behaviour, including harmful behaviour. The purpose of this paper is to discuss the evolutionary importance of social belonging, and also its relevance to why people deny stigmatised harmful behaviour, and the potential problems of labelling them by it.Design/methodology/approachThe paper takes the form of a discussion and professional opinion.FindingsEvolution reveals how natural selection has shaped the human nervous system for threat-detection and cooperation. It casts a light on why people convicted of harmful and stigmatised behaviour may hide, deny and lie as a means of limiting social devaluation and maintaining their fitness to belong in groups.Practical implicationsAmidst all our efforts as forensic practitioners to empower people to pro-socially reconnect and lead safer crime-free lives, endlessly associating them with their most unacceptable and harmful acts, might not help.Originality/valueEvolutionary forensic psychology and evolutionary criminology are sub-disciplines of science that are progressively emerging. They place the adaptationist approach front and centre in the study and theory of criminal behaviour. This paper aims to offer an example of this synergy, but with a specific focus on forensic practice itself.

Purpose A high proportion of forensic mental health service users (FSUs) are recalled to secure hospitals from conditional discharge in the community. The limited research on recall to date has preliminarily identified why FSUs are recalled, but not how they make sense of the process. The purpose of this paper is to develop a conceptual understanding of how FSUs make sense of being recalled to hospital. Design/methodology/approach A constructivist grounded theory approach was used. Semi-structured interviews were carried out with 11 FSUs from different levels of forensic service security who had been recalled varying numbers of times across a wide timeframe. Findings A theoretical model was constructed to illustrate the process of how FSUs make sense of being recalled. FSUs appraise being recalled on a continuum from negative to positive, based on their experiences when conditionally discharged and their reflections on the circumstances of being recalled. The nature of their appraisal appears to reciprocally influence their subsequent attitudes towards and their engagement with forensic services. Research limitations/implications The proposed mechanism of how FSUs make sense of being recalled, particularly their dynamic appraisal of it, should now be investigated longitudinally. Future qualitative research could explore forensic service staff perspectives on recall. Practical implications Enhancing the positivity of FSUs’ appraisals about being recalled may improve their attitudes about and engagement with forensic services. Originality/value This is the first research study to construct a theoretical model of recall.

PurposeThe purpose of this paper is to evaluate the prevalence of mental health disorder symptoms in a sample of prisoners in Trinidadian prisons who volunteered to attend anger management groups.Design/methodology/approachA survey was conducted using the 90-item Symptom Check-List revised (SCL-90-R) which was administered to prisoners in groups within the prison system. In total 132 prisoners (about 9 per cent of the prison population) completed the measure. The effect sizes of prisoners’ similarities to a psychiatric inpatient group and their differences from a non-patient group were used to identify symptoms most indicative of pathology in these prisoners.FindingsThe results on the SCL-90-R indicate that this group of prisoners (77.3 per cent male) had scores of psychiatric symptomatology that were much closer to a psychiatric inpatient population rather than to a general community population.Practical implicationsThese results suggest there may be unmet psychiatric need among the population served by the prison services in Trinidad. It is not known how this sample differs from the general prison population. However, the unmet psychiatric need in this specific population suggests that a greater mental health focus in health services within prisons is to be considered to meet these needs.Originality/valueThese data suggest that there are significant mental health issues for some prisoners in Trinidad and possibly more generally in similar prison systems within the Caribbean and this may have significant implications for the treatment of prisoners and the delivery of mental health services in these prisons.

PurposeClinical professionals working with psychologically traumatised children in the care system can experience potential challenges maintaining their own positive psychological health, and when repeatedly being exposed to the traumatic histories of those in their care. The purpose of this paper is to increase the understanding of vicarious trauma and provide a guide for focussing on future research.Design/methodology/approachThis is a systematic literature review, considering 13 articles that met the criteria and identified five main themes linked to secondary traumatic stress/vicarious trauma in staff.FindingsFive main themes were noted. These are: lack of organisational support; lack of health work-life balance; lack of appropriate training; failure to use self-care techniques; and staff failure to share when they are experiencing symptoms.Practical implicationsVarious implications are noted from this review. These include: the importance of education and support for staff, to be mindful that newer staff may be considered an “at risk” group for the negative impact of such trauma, and to encourage staff in achieving an effective work-life balance.Originality/valueThis is a focussed systematic review on secondary and vicarious trauma on staff working with children exposed to psychological trauma, such as sexual and physical abuse.

PurposeIntermediaries facilitate communication with many types of vulnerable witnesses during police investigative interviews. The purpose of this paper is to find out how intermediaries engage in their role in cases where the vulnerable witness presents with one type of vulnerability, namely, dissociative identity disorder (DID).Design/methodology/approachIn phase 1, data were obtained from the National Crime Agency Witness Intermediary Team (WIT) to ascertain the demand for intermediaries in DID cases in England and Wales within a three-year period. In phase 2 of this study four intermediaries who had worked with witnesses with DID completed an in-depth questionnaire detailing their experience.FindingsReferrals for DID are currently incorporated within the category of personality disorder in the WIT database. Ten definite DID referrals and a possible additional ten cases were identified within this three-year period. Registered Intermediary participants reported having limited experience and limited specific training in dealing with DID prior to becoming a Registered Intermediary. Furthermore, intermediaries reported the many difficulties that they experienced with DID cases in terms of how best to manage the emotional personalities that may present.Originality/valueThis is the first published study where intermediaries have shared their experiences about DID cases. It highlights the complexities of obtaining a coherent account from such individuals in investigative interviews.

PurposeThe purpose of this paper is to explore the experiences of both staff and patients in a medium-secure mental health unit of the self-harm and/or suicidal behaviour of others. Suicide and self-harm is highly prevalent in forensic settings and evidence suggests that experiencing other people’s self-harm and suicidal behaviour can lead to negative outcomes, both for staff and patients. This is particularly important in hospitals where patients are highly dependent on staff for support.Design/methodology/approachSemi-structured interviews were conducted with five staff members and six patients in a medium-secure male mental health unit in the North of England. Data were analysed following interpretative phenomenological analysis guidelines.FindingsThree dominant themes were identified during analysis: the impact of suicide and self-harm; the role of others; and the importance of understanding and experience. Various impacts were discussed including desensitization, negative emotions and the desire to help. Other people played an important role in protecting against negative impacts, with shared experiences and peer support reported as the biggest benefits. Experiences of self-harm and suicide were found to increase understanding resulting in more positive attitudes. Additionally, the importance of training and education was highlighted.Originality/valueThis paper provides an insight into the experiences of staff and patients in medium-secure male mental health unit, which has benefits to practitioners when considering support mechanisms.

PurposeThe purpose of this paper is to study weight changes during psychiatric hospitalization, so as to identify “obesogenic” features in a mixed (forensic and rehabilitation) inpatient service.Design/methodology/approachAn observational study of psychiatric inpatients, gathering sociodemographic, clinical, weight, dietary and sleep information and an actigraphic assessment.FindingsA total of 51 patients, aged 19-68, 40 males, participated at a median of 13 months after their admission. When studied, only 6 percent had a healthy weight, 20 percent were overweight and three quarters (74 percent) were obese. The mean Body Mass Index (BMI) was 35.3 (SD: 8.1). At admission, only three patients (8.3 percent) had healthy BMIs and over the course of their hospital stay, 47 percent gained further weight. A high proportion was physically inactive and half slept more than nine hours a day. Participants received high calorie diets and half (53 percent) smoked cigarettes.Practical implicationsAlthough antipsychotic medication is known to cause weight gain, this should not be seen in isolation when attempting to explain psychiatric inpatient obesity. An inpatient admission is an opportunity to provide a healthier eating environment, health education and assertively promote less sedentary behavior and healthier sleep habits.Social implicationsObesity adds to the burden of this already significantly disadvantaged group of patients.Originality/valueThe results confirm earlier research showing that forensic and rehabilitation psychiatric inpatients as a group are obese, gain weight while in hospital and often smoke. The authors add data demonstrating that they are often physically inactive, sleep excessively and consume an unhealthy diet despite the provision of health focused interventions as an integral part of their inpatient program.