ABSTRACT
There is a lack of agreement about the prevalence of learning disability (LD) in forensic populations; however, what figures we do have to suggest an over-representation. Additionally, there is a tendency towards diagnostic overshadowing and managing patients and prisoners as a homogenous rather than heterogeneous group. This significantly limits our understanding of the complexities of this population impacting our ability to provide person-centred care. Current literature suggests that individuals with LD are more likely to experience traumatic and negative life events including systemic abuse and neglect over long periods of time than those without. Trauma symptoms are known to be exacerbated by compulsory detainment in high secure care. This raises several issues when working with patients with LD, particularly within the UK National High Secure LD Service. This chapter will explore some of the current issues facing clinicians and patients within forensic LD services. It will pay particular attention to recent developments in understanding LD from a developmental trauma perspective and the implications of this on interventions, successful progression, and community forensic provisions. A case study with quotes from an African-British patient with LD in high secure care is included to give voice to his experiences in the criminal justice and forensic mental health systems.
