Catanesi and colleagues are to be commended on their publication of a substantial survey of patients in the Italian ‘Residences for the Execution of Security Measures’ (REMS). The REMS system consists of a regional system of around 30 secure units, focussing on mental health recovery and rehabilitation rather than the high security and more penitentiary-like large hospitals they replaced (the six Ospedali Psichiatrici Giudiziari, OPGs). These smaller units, however, with approximately 20 beds each, only provide approximately a third of the capacity of the OPGs (604 beds versus 1639), raising the important issue of the characteristics of the patients who are admitted to this new, reorganized forensic mental healthcare system. This is the question Catanesi and colleagues answer. Between June 2017 – June 2018, they detailed the socio-demographic, criminological and mental health characteristics of over 95% of those residing in the REMS.