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ObjectivesThis study examined the point prevalence of patients with intellectual and developmental disabilities (IDDs) in Ontario forensic inpatient units and compared the demographic, clinical, and system-level profiles of long-stay forensic patients with and without IDD.MethodThis cross-sectional study utilized Ontario administrative health data held at ICES. All patients over 18 years of age who occupied an Ontario forensic inpatient bed on 30th September 2023 were included in the analysis. Focus was given to patients with a length of stay (LOS) of at least 365 days (i.e., "long-stay" patients). Within this group, the prevalence of IDD was assessed, and patients with and without IDD were compared on their demographics, clinical characteristics, LOS, and support needs using standardized differences (StdDiff).ResultsAmong long-stay forensic patients (n = 549), 42.4% had IDD. Long-stay forensic patients with and without IDD had a mean age of 43 years, and the majority of patients in both groups were male (87.6% vs. 90.8%; StdDiff = 0.105). In the 2 years prior to admission, the majority of all long-stay patients were diagnosed with a psychotic disorder, though the proportion was higher among patients without IDD (80.3% vs. 92.1%; StdDiff = 0.348). Long-stay patients with IDD had a substantially longer LOS (mean LOS = 7.2 years vs. 4.9 years; StdDiff = 0.459) and were more likely to be restrained (5.2% vs. 2.2%; StdDiff = 0.156). A higher proportion of long-stay patients with IDD had difficulty with activities of daily living (23.2% vs. 11.7%; StdDiff = 0.306), and severe cognitive impairment (14.6% vs. 6.6%; StdDiff = 0.260).ConclusionsThis study found that almost half of long-stay forensic patients had IDD and this patient group had different demographic and clinical profiles from other patients, which may impact their support needs within the hospital and pose barriers to discharge.