Treatment resistant schizophrenia (TRS) represents patients suffering with the severe end of the disorder spectrum. Forensic patients with TRS present an additional consideration with regards to their risk of violence. This study aims to establish the prevalence and corresponding disability levels of such patients within all three security levels in typical forensic hospitals in the UK.

This is a retrospective cross sectional study of case notes to identify patients who fulfill the criteria for TRS. To identify the disability caused by TRS, the patients length of inpatient stay and incident record will be used. All data will be anonymised and kept confidential, only known to the named researchers.

Forensic patients with TRS form a significnant cohort in secure forensic hospitals. These patients often are the most unwell and present with significant risk of violence, despite being on conventional treatment. In addition, this group of patients are unlikely to be able to meaningfully participate in psycho-social therapy such as offending behaviour work or occupational therapy. Hence perpetuating their duration of detention within secure hospitals. This leads to a spiralling effect where these patients become institutionalised following protracted periods of detention, resulting in further disability than caused by the effect of the disorder on its own. This study aims to identify this cohort within a representative sample of secure hospitals in the UK.