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

Br J Psychiatry. 2007 Jul:191:70-4. doi: 10.1192/bjp.bp.106.029215.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cause of Death*
  • Commitment of Persons with Psychiatric Disorders / statistics & numerical data*
  • Crime / classification
  • Crime / psychology*
  • Crime / statistics & numerical data
  • Employment / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Hospitals, Psychiatric / statistics & numerical data
  • Humans
  • Male
  • Mental Disorders / mortality*
  • Patient Discharge / statistics & numerical data*
  • Risk*
  • Suicide / statistics & numerical data
  • Treatment Outcome
  • United Kingdom / epidemiology
  • Violence / statistics & numerical data