Forensic mental health services in the United Kingdom and Ireland

The UK and Ireland have a long record of providing specialist secure mental health services in health service hospitals, and a more recent one of specialist community services for offender-patients. This chapter examines the development and provision of such services, so mainly about the framework for delivering specialist assessments and treatments rather than those tasks themselves. A new tier of medium security hospital services was developed, forensic psychiatry specialist training was established in the UK and Ireland and an academic base took a tenuous hold. Fear and intolerance of people who have a mental illness has a long history, partly because of a perception, which goes back at least into ancient Greece, that violence as well as ‘wandering about’ is characteristic of mental disorder. In specialist forensic mental health services, physical security refers to the nature of the perimeter walls or fence and the internal building design.