Mortality among forensic psychiatric patients in Finland

Both mental illness and criminality are associated with higher risk of early death, yet the mortality among forensic psychiatric patients who are affected by both mental illness and criminal behaviour has scarcely been studied.

To analyse the mortality among all patients who were committed to a compulsory forensic psychiatric hospital treatment in Finland between 1980 and 2009. Mortality was analysed according to the age when the patient was committed to forensic treatment.

A total of 1253 patients were included, of which 153 were females and 1100 were males. The mean follow-up time in this study was 15.1 years, and 351 (28%) had died during the follow-up period. The standardized mortality rate (SMR) for the whole study group was 2.97 (95% CI 2.67-3.29). Among females the SMR was 3.62 (95% CI 2.57-5.09), and among males 2.91 (95% CI 2.61-3.25). The SMRs were higher when patients were committed to forensic treatment before the age of 40 years.

This study showed an increased mortality among forensic psychiatric patients compared with the general population and the mortality was inversely proportional to the age when the treatment had begun. In contrast to the earlier studies, the mortality in this study was lower indicating that prolonged treatment may have an overall protective effect on forensic psychiatric patients.