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Published on: September 30, 2020
Long-term outcomes after discharge from medium secure care: a cause for concern
Steffan Davies1, Martin Clarke, Clive Hollin
1Arnold Lodge, East Midlands Centre for Forensic Mental Health, Cordelia Close, Department of Health Sciences, University of Leicester, LE5 0LE, UK.
Summary
Patients discharged from UK medium secure units face significantly higher mortality risks and high rates of reconviction and readmission. Enhanced community support is crucial for this vulnerable population.
Area of Science:
- Forensic Psychiatry
- Mental Health Services Research
- Public Health
Background:
- Medium secure units (MSUs) in the UK have existed for over two decades.
- Long-term follow-up studies of patients discharged from MSUs are scarce.
- Understanding post-discharge outcomes is critical for patient care and public safety.
Purpose of the Study:
- To investigate long-term outcomes for patients discharged from UK medium secure units.
- To quantify rates of mortality, reconviction, violent behavior, readmission, and employment.
- To identify the need for improved post-discharge support services.
Main Methods:
- A 20-year follow-up study of 550 patients discharged from medium secure units.
- Inclusion of 595 first admissions over the study period.
- Utilized multiple data sources for comprehensive data collection.
Main Results:
- Mortality rate was six times higher than the general population, with 10% of patients dying.
- Suicide accounted for 32% of all deaths among discharged patients.
- Nearly half (49%) of discharged patients were reconvicted, and 38% were readmitted to secure care.
Conclusions:
- Discharged patients from medium secure care represent a highly vulnerable group.
- Enhanced community psychiatric services and careful follow-up are essential.
- Intervention is needed to prevent excess mortality, psychiatric morbidity, and further offending.
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