Patients discharged from medium secure forensic psychiatry services: reconvictions and risk factors.
BACKGROUND
Treatment within medium secure forensic psychiatry services is expected to reduce risk to the public.


OBJECTIVE
To measure the period prevalence and incidence of offending following discharge and identify associated risk factors.


METHODS
Follow-up of patients from 7 of 14 regional services in England and Wales who spent time at risk (n=1344) for a mean of 6.2 years. Outcome was obtained from offenders index, hospital case-files and the central register of deaths.


RESULTS
One in 8 men and 1 in 16 women were convicted of grave offences. Incidence rates indicated low density and most patients were not subsequently convicted. Offence predictors included gender, younger age, early-onset offending, previous convictions and a comorbid or primary diagnosis of personality disorder. Longer in-patient stay and restriction on discharge were protective.


CONCLUSIONS
Risks of reoffending remain for a subgroup of discharged patients. Future research should aim to improve their identification and risk management following discharge.
Coid
Jeremy
J
Forensic Psychiatry Research Unit, St Bartholomew's Hospital, William Harvey House, 61 Bartholomew Close, London EC1A 77BE, UK. j.w.coid@qmul.ac.uk
Hickey
Nicole
N
Kahtan
Nadji
N
Zhang
Tianqiang
T
Yang
Min
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D003415:Crime / Q000706:statistics & numerical data*; D003688:Deinstitutionalization / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005555:Forensic Psychiatry / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D012308:Risk Management; D014852:Wales / Q000453:epidemiology