AbstractA follow‐up study of the first six clients to leave the Mental Impairment Evaluation and Treatment Service is described. Between entering the service and follow‐up (mean: 12 months after leaving), all six had made gains in their levels of skills and social functioning. For five of them, there had also been a reduction in the key challenging behaviours for which referral had been sought. All were living in residential facilities which were both less restrictive than those from which they had entered the service and offered a higher quality of care. The majority liked the placement in which they were living at follow‐up as much, or more, than the one from which they had entered the service. Nevertheless, some of the resources which assist the functioning of the service were disliked by the clients because they were perceived as placing limits on their liberty. The implications of these results are discussed, as are methodological issues relating to the