Clinical characteristics of community forensic mental health services

Community forensic mental health teams are a new service within the widening range of specialized community mental health services. The characteristics of these novel services are poorly defined. Two commonly described service models in the United Kingdom are the integrated model (forensic specialists working within community mental health teams) and the parallel model (forensic specialists working on a separate specialist team). The study reported here aimed to establish clear definitions of these service models.

A literature review and a focus group of ten service professionals were conducted to identify candidate characteristics of services in community forensic mental health teams. A total of 31 characteristics were identified and used to prepare the first-round questionnaire for the two rounds of a modified Delphi consultation, which is an expert opinion and consensus method, with a multidisciplinary panel of 32 mental health professionals experienced in community forensic work.

Twenty-nine staff (91 percent) completed the two rounds of consultation. Thirteen service characteristics differentiated the integrated and parallel models. Key characteristics of parallel teams included having their own team base, separate referral meetings, a specialist management line, specialist supervision, protected funding, forensic psychology, good links with criminal justice systems, and capped caseloads. Integrated teams were distinguished by their close links with community mental health services and acceptance of more referrals from primary care.

Integrated and parallel models of community forensic mental health teams differ on many service characteristics. Defining these characteristics will help in researching the pros and cons of each model in the treatment and risk management of mentally ill offenders in the community.