Patients discharged from medium secure forensic psychiatryservices: reconvictions and risk factors

• Published in: British journal of psychiatry 2007-03, Vol.190 (3), p.223-229
• Main Authors: Coid Jeremy, Hickey, Nicole, Nadji, Kahtan, Zhang Tianqiang, Yang, Min
• Format: Article
• Language: English
• Subjects: Age; Age of onset; Arson; Comorbidity; Court decisions; Density; Forensic psychiatry; Forensic science; Inpatient care; Medical records; Mental disorders; Mental health care; Minority & ethnic groups; Offenders; Offending; Offenses; Patients; Personality disorders; Psychiatry; Public safety; Recidivism; Restrictions; Risk factors; Risk reduction
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.bp.105.018788

BackgroundTreatment within medium secure forensic psychiatry services is expectedto reduce risk to the public.AimsTo measure the period prevalence and incidence of offending followingdischarge and identify associated risk factors.MethodFollow-up of patients from 7 of 14 regional services in England and Waleswho spent time at risk (n=1344) for a mean of 6.2 years.Outcome was obtained from offenders index, hospital case-files and thecentral register of deaths.ResultsOne in 8 men and 1 in 16 women were convicted of grave offences.Incidence rates indicated low density and most patients were notsubsequently convicted. Offence predictors included gender, younger age,early-onset offending, previous convictions and a comorbid or primarydiagnosis of personality disorder. Longer in-patient stay and restrictionon discharge were protective.ConclusionsRisks of reoffending remain for a subgroup of discharged patients. Futureresearch should aim to improve their identification and risk managementfollowing discharge.