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The purpose of this discussion paper is to describe the transition over the past five years of a highly specialist group treatment programme to a tiered public health delivery model within the offender personality disorder (OPD) pathway. The focus of this journey of transformation has been the Challenge programme, currently the only OPD specialist service for men with sexual convictions in the community in England and Wales, and now a pan-London service.

More than 600 high-risk men with sexual convictions are screened into the OPD pathway and reside currently in the community across London. The programme leads have developed a triage model – based on the wider OPD model – that applies the principles of the least intervention necessary and the most effective use of limited resources.

Preliminary informal feedback was sought on the new consultation approach and innovative joint casework delivery models. The model of care is discussed in relation to the preliminary feedback, which was encouraging in terms of satisfaction with the consultation service and in terms of the people on probation who found that participating in the joint casework enhanced their working relationship with offender managers. The consistent use of a single model of care and a careful triage approach across the city to working with this group of individuals is still in development. Early feedback suggests that the service has to potential to be effective, but establishing this requires formal evaluation.

Practice implications include the need to address the lack of confidence that many practitioners report when working with people with sexual convictions. Virtually delivered group consultation may enhance the development of skills as it may providing a flexible toolkit for delivery.

This practice paper describes the only specialist community service for men with high-risk, high-harm sexual convictions and personality difficulties in the UK.

This is a discussion paper describing the reflections of clinical leads within well-established intensive intervention and risk management services (IIRMS). IIRMS has developed in the past five years, with a small number of services leading in the development of a psychologically informed case management approach to working with individuals released from prison on probation licence, who have a history of high risk, high harm violent convictions linked to pervasive psychological and interpersonal problems.

Clinical leads of three services considered a period of 23 months up to December 2019, in which the outcomes for all individuals on their caseload at that time were reviewed. Reflections on the themes included the reasons for a premature return to prison and emerging themes for those who appeared to be successfully resettled.

Approximately one-third of the individuals were returned to prison, and for most, this occurred within the first 18 months of release. There was considerable unanimity between clinical leads regarding the themes, and problems with relative youth, substance misuse, relationship difficulties, managing transitions and complacency featured. There were four themes identified in those who appeared to have settled successfully in the community.

The identified themes provide key learning that will be enshrined in an updated version of the guidance for all IIRMS, with the overall aim of reaching out and engaging with a group of individuals who are most at risk of exclusion from services.

Although there are limitations associated with the informal approach of this paper, the reflections of the clinical leads have provided a valuable addition to the very limited empirical literature in this field.

This article presents the findings of a study of the victimisation of three cohorts of young people living in a county town in the East Midlands. Following a brief review of research into contemporary youth victimisation in the UK, it reports the findings of the study and discusses the reasons for variations in rates of victimisation between the three cohorts. It concludes with a discussion of the implications for professionals.

In this article Alison Cameron of Dual Recovery Anonymous talks about the complexity of dual diagnosis and tells the story of her experiences as a service user and her own journey of recovery.

Sarah Hill introduces a new, regular section from the National Social Inclusion Programme (NSIP) on policy developments and best practice in social inclusion and mental health.

Dual diagnosis poses particular challenges for inpatient mental health services. Workers have low levels of training, clinical experience and support to deliver integrated care that combines mental health and substance use interventions. In addition, inpatient workers have to balance being therapeutic with ensuring that illicit substance use does not occur on the wards. This often leads to confrontation and poor engagement.In order to improve the capabilities of the workers to deliver more effective interventions for this group of service users, dual diagnosis training should be a high priority for acute inpatient services. However, there are a number of challenges in the implementation of this including lack of resources to fund training and specialist roles, lack of time to attend training (and supervision), and lack of time to implement learning in routine care.This paper will describe the policy drivers for the improvement of dual diagnosis care in acute psychiatric inpatient services, and how two initiatives in London are overcoming some of the obstacles and showing some promising initial outcomes. This paper will make recommendations for future research and developments.