title: Comparison of outcomes following after-care from forensic and general adult psychiatric services.
abstract: BACKGROUND
  Forensic psychiatry services are expanding in England and Wales but require support from general services for patient after-care.
  
  
  OBJECTIVE
  To compare outcomes following community after-care from forensic or general adult psychiatry services.
  
  
  METHODS
  An observational comparison was made of case management following discharge from medium security in seven pre-reorganisation health regions of England and Wales, by forensic services (n=409) and general adult services (n=652). Criminal convictions, hospital readmissions and deaths were compared over a mean follow-up period of 6.2 years, adjusting for difference in case mix.
  
  
  RESULTS
  Forensic services did not supervise more high-risk patients in the community. Neither service was superior in outcome. More patients managed by general services died from natural causes.
  
  
  CONCLUSIONS
  Neither service was superior on measures of subsequent offending or hospitalisation. Specialist forensic after-care conveyed no added benefit. Case management may have been the same in both services.
authors.affiliation: Forensic Psychiatry Research Unit, St Bartholomew's Hospital, 61 Bartholomew Close, London EC1A 7BE, UK. j.w.coid@qmul.ac.uk
authors.forename: Jeremy W
authors.initials: JW
authors.lastname: Coid
authors.forename: Nicole
authors.initials: N
authors.lastname: Hickey
authors.forename: Min
authors.initials: M
authors.lastname: Yang
mesh_terms: D000328:Adult; D000359:Aftercare; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D016896:Treatment Outcome