Secure services for people with learning disabilities

Section A: A review of qualitative literature exploring people with learning disabilities’ experiences of secure forensic services. Critical appraisal of the 12 included studies is discussed. Thematic synthesis resulted in three analytical themes with eight sub-themes. Analytical themes included ‘it’s not the ideal place to live’, ‘relationships within the unit’ and ‘change’. Implications for clinical practice are considered, including helpful and unhelpful
aspects of secure services as experienced by people with learning disabilities. Recommendations for future research include further exploration of the experience of psychological interventions for people with a learning disability within secure settings.

Section B: A study exploring the process by which psychology is offered within a low secure learning disability service, and resulting willingness to attend psychology. Guided by
constructivist grounded theory methodology, the constructed model identifies four domains:‘context of the offer’, ‘drive to engage patients in psychology’, ‘navigating making the offer’,‘making sense of the offer’. Interactions between these are highlighted. Findings emphasise the challenges of the dual role of staff within a forensic setting and how navigation of this may translate into patient’s receiving a mixed message regarding choice, and resulting willingness
to attend psychology. Implications for further research and clinical practice are discussed.