As the policy of community care is translated into reality a number of challenges are beginning to appear on the horizon, including the identification of client groups whose members are proving difficult to serve. People with severe mental handicaps who exhibit severe problem behaviours are one such group (DHSS, 1984; King's Fund, 1987).This paper introduces a series of articles to be published in Mental Handicap that will explore the provision of community based services for this client group. The series will focus on issues arising from the work of the South East Thames Regional Health Authority's Special Development Team.

This is the second in a series of articles in MentalHandicap that explore the provision of community based services for people with severe mental handicaps and challenging behaviours. It presents information arising from the work of the South East Thames Regional Health Authority's Special Development Team that begins to answer the basic question: who are the people with severe mental handicaps whose behaviour poses a major challenge to current services?

This paper describes the process of individual service planning used by the South East Thames RHA's Special Development Team to develop comprehensive, locally based services for people with severe mental handicaps and challenging behaviours. The framework described is used as a basis from which to begin to address the question: What will it take to design and implement a high quality, locally based service programme for this person under these conditions in this particular organisation?

This paper describes some important aspects of setting up community based services for people with severe mental handicaps and challenging behaviours. These include the selection and furnishing of property, the development of comprehensive operational policies, and the recruitment and training of staff.