title: Conditionally discharged restricted patients and the need for long-term medium security.
abstract: In the context of a larger investigation of follow-up of a specific group of mentally disordered individuals, the study described here examined the characteristics of all 55 people conditionally discharged for the first time from a medium secure unit in the West Midlands over a 13-year period. A retrospective case note analysis was undertaken. The findings illustrate that these patients are a distinct group. They were mainly single men who had committed a grave offence. The majority had an extensive criminological history with early onset of offending and chronic mental illness. Fifty percent of those with a criminal record had received at least one custodial sentence prior to the index offence. Co-morbid substance misuse was common, as was a history of self-harm. There were high levels of previous contact with psychiatric services and compulsory in-patient treatment. Most were detained under the Mental Health Act category of mental illness. A quarter had been transferred from a special hospital prior to conditional discharge into the community. The characteristics of this sample demonstrate clearly the need for the provision of long-term medium secure facilities and allied services.
authors.affiliation: The University of Birmingham and South Birmingham Mental Health NHS Trust, Reaside Clinic, Birmingham Great Park, Bristol Road South, Birmingham B45 9BE.
authors.forename: Sharon
authors.initials: S
authors.lastname: Riordan
authors.forename: Helen
authors.initials: H
authors.lastname: Smith
authors.forename: Martin
authors.initials: M
authors.lastname: Humphreys
mesh_terms: D000328:Adult; D000368:Aged; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D003415:Crime / Q000706:statistics & numerical data*; D005260:Female; D006778:Hospitals, Psychiatric / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008875:Middle Aged; D010045:Outpatients; D012189:Retrospective Studies; D012637:Security Measures; D012949:Social Work, Psychiatric