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Discharges to prison from medium secure psychiatric units in England and Wales
Michael Doyle1, Jeremy Coid1, Laura Archer-Power1
1Michael 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.
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.
Aims:
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.
Method:
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.
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