title: Long-term outcome from a medium secure service for people with intellectual disability.
abstract: BACKGROUND
  The purpose of this paper is to describe long-term outcomes for patients discharged over a 12-year period from a medium secure service for people with intellectual disabilities (ID).
  
  
  METHODS
  A cohort study using case-notes analysis and a structured interview of current key informants.
  
  
  RESULTS
  Eleven per cent of the sample was reconvicted. Fifty-eight per cent of the sample showed offending-like behaviour that did not lead to police contact. Twenty-eight per cent of the sample was currently detained in hospital under the Mental Health Act. The presence of a personality disorder, a history of theft or burglary, and young age increased the risk of reconviction. Contact with the police was less likely in those with schizophrenia. Re-admission to hospital was associated with the presence of offending-like behaviours, rather than any specific diagnosis.
  
  
  CONCLUSIONS
  In terms of reconviction, these results are good compared with those from general forensic services; however, behavioural problems continue for many years and are managed without recourse to the criminal justice system. There is a borderline group whose needs are poorly defined and serviced. Declaration of interests Horizon National Health Service Trust, the managing authority of the service, gave the grant for this study; the corresponding author was working in the service.
authors.affiliation: St John's House Hospital, Norfolk, UK.
authors.forename: R T
authors.initials: RT
authors.lastname: Alexander
authors.forename: K
authors.initials: K
authors.lastname: Crouch
authors.forename: S
authors.initials: S
authors.lastname: Halstead
authors.forename: J
authors.initials: J
authors.lastname: Piachaud
mesh_terms: D015331:Cohort Studies; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D015897:Comorbidity; D003415:Crime / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology* / Q000534:rehabilitation; D007360:Intelligence; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D010554:Personality Disorders / Q000453:epidemiology / Q000534:rehabilitation; D012307:Risk Factors; D012637:Security Measures; D012920:Social Behavior Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D016896:Treatment Outcome