Long-term outcomes after discharge from medium secure care: A cause for concern

Abstract

Background: There are few long-term follow-up studies of patients discharged from medium secure units in the UK, even though these units were introduced over 20 years ago. Aims: To describe mortality, rates of reconviction at different time periods; violent behaviour (not leading to conviction), readmission and employment, after discharge from a medium secure unit. Method: Of 595 first admissions over a 20-year period, 550 discharged cases were followed-up. Multiple data sources were used. Results: Fifty-seven (10%) patients had died, of whom 18 (32%) died by suicide, and the risk of death was six times greater than in the general population. Almost half (49%) of those discharged were reconvicted and almost two-fifths (38%) of patients were readmitted to secure care. Conclusions: Community psychiatric services need to be aware that those discharged from medium secure care are a highly vulnerable group requiring careful follow-up if excess mortality, high levels of psychiatric morbidity and further offending are to be prevented.