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Published on: November 21, 2013
Patients discharged from medium secure forensic psychiatry services: reconvictions and risk factors
Jeremy Coid1, Nicole Hickey, Nadji Kahtan
1Forensic Psychiatry Research Unit, St Bartholomew's Hospital, William Harvey House, 61 Bartholomew Close, London EC1A 77BE, UK. j.w.coid@qmul.ac.uk
Background:
Treatment within medium secure forensic psychiatry services is expected to reduce risk to the public.
Aims:
To measure the period prevalence and incidence of offending following discharge and identify associated risk factors.
Method:
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.
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