title: Discharges to prison from medium secure psychiatric units in England and Wales.
abstract: BACKGROUND
  Early findings from a national study of discharges from 32 National Health Service medium secure units revealed that nearly twice as many patients than expected were discharged back to prison.
  
  
  OBJECTIVE
  To compare the characteristics of those discharged back to prison with those discharged to the community, and consider the implications for ongoing care and risk.
  
  
  METHODS
  Prospective cohort follow-up design. All forensic patients discharged from 32 medium secure units across England and Wales over a 12-month period were identified. Those discharged to prison were compared with those who were discharged to the community.
  
  
  RESULTS
  Nearly half of the individuals discharged to prison were diagnosed with a serious mental illness and over a third with schizophrenia. They were a higher risk, more likely to have a personality disorder, more symptomatic and less motivated than those discharged to the community.
  
  
  CONCLUSIONS
  Findings suggest that alternative models of prison mental healthcare should be considered to reduce risks to the patient and the public.
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Doyle
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Coid
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Archer-Power
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Dewa
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Hunter-Didrichsen
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Stevenson
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Verity
authors.initials: V
authors.lastname: Wainwright
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Costas
authors.initials: C
authors.lastname: Kallis
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Simone
authors.initials: S
authors.lastname: Ullrich
authors.affiliation: Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Shaw
mesh_terms: D004739:England; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D010351:Patient Discharge; D011330:Prisons; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D014852:Wales