Patients discharged from medium secure forensic psychiatry services: Reconvictions and risk factors

Abstract

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.