Background The physical healthcare needs of patients in medium secure units (MSUs) are often overlooked. The authors of this article audited patients in one forensic MSU to establish the extent of the problem and patients’ desire to lead a healthy lifestyle.

Conclusion Fifty six patients were questioned using semi-structured interviews. The number of patients who smoke was found to be disproportionately high (84 per cent) compared to the general UK population (27 per cent). The authors also found a correlation between length of stay on the unit and increase in body mass index. The authors describe measures taken to promote the physical wellbeing of patients in the unit.