title: Long-term outcomes after discharge from medium secure care: a cause for concern.
abstract: BACKGROUND
  There are few long-term follow-up studies of patients discharged from medium secure units in the UK, even though these units were introduced over 20 years ago.
  
  
  OBJECTIVE
  To describe mortality, rates of reconviction at different time periods; violent behaviour (not leading to conviction), readmission and employment, after discharge from a medium secure unit.
  
  
  METHODS
  Of 595 first admissions over a 20-year period, 550 discharged cases were followed-up. Multiple data sources were used.
  
  
  RESULTS
  Fifty-seven (10%) patients had died, of whom 18 (32%) died by suicide, and the risk of death was six times greater than in the general population. Almost half (49%) of those discharged were reconvicted and almost two-fifths (38%) of patients were readmitted to secure care.
  
  
  CONCLUSIONS
  Community psychiatric services need to be aware that those discharged from medium secure care are a highly vulnerable group requiring careful follow-up if excess mortality, high levels of psychiatric morbidity and further offending are to be prevented.
authors.affiliation: Arnold Lodge, East Midlands Centre for Forensic Mental Health, Cordelia Close, Department of Health Sciences, University of Leicester, LE5 0LE, UK.
authors.forename: Steffan
authors.initials: S
authors.lastname: Davies
authors.forename: Martin
authors.initials: M
authors.lastname: Clarke
authors.forename: Clive
authors.initials: C
authors.lastname: Hollin
authors.forename: Conor
authors.initials: C
authors.lastname: Duggan
mesh_terms: D000328:Adult; D002423:Cause of Death; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D003415:Crime / Q000145:classification / Q000523:psychology* / Q000706:statistics & numerical data; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000401:mortality*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012306:Risk; D013405:Suicide / Q000706:statistics & numerical data; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data