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This paper sets current proposals for reform of mental health legislation in the context of historical development of care for mentally disordered offenders and those who require similar services. The authors reflect on the fact that the National Service Framework and the various documents related to reform of the Mental Health Act 1983, seem to do little to address the area of the treatment of people suffering from psychiatric disorders who fall foul of the criminal justice system and bring little that is new to the field of forensic practice. They suggest that the ‘safety first’ approach seems still to be paramount.

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