Psychiatric admissions at different levels of the national health care services and male criminality: the Northern Finland 1966 Birth Cohort study.
BACKGROUND
It has earlier been suggested that one-third of violent offenders are recorded in psychiatric case registers. Our aim was to study whether violent and non-violent offenders differ with respect to admissions to any health care inpatient service due to psychiatric disorders.


METHODS
We used a genetically homogeneous, general population database from the Northern Finland 1966 Birth Cohort, together with the Finnish Hospital Discharge Register and national crime registers.


RESULTS
We found that one-third of violent and one-fourth of non-violent male offenders had at least one hospital admission due to a psychiatric disorder before the age of 32. Sixty-five violent criminals - 1.2% of all cohort males (n = 5636) - accounted for 14.4% of all psychiatric treatment days. The admission rates among both violent and non-violent male offenders were significantly higher when compared with males with no criminal history. Among violent males, only half (55.5%) of the inpatient hospital days due to psychiatric disorders occurred in psychiatric hospitals. The corresponding percentages for non-violent criminals and non-criminals were 64.9% and 74.1%, respectively. Among the violent offenders, one-third of hospital inpatient days occurred in university hospitals or central hospitals, and only 1.9% of them occurred in a comprehensive community care system.


CONCLUSIONS
Violent offenders' admission rates due to a psychiatric diagnosis are high, and they are frequently treated at an inappropriate health care level.
Timonen
M
M
Department of Psychiatry, University of Oulu, and Ylikiiminki Health Centre, Finland.
Miettunen
J
J
Hakko
H
H
Järvelin
M R
MR
Veijola
J
J
Kinnunen
J
J
Räsänen
P
P
D000328:Adult; D002391:Catchment Area, Health; D015331:Cohort Studies; D003415:Crime; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D008605:Mental Health Services / Q000600:supply & distribution*; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D014754:Violence / Q000523:psychology