The fate of medium secure patients discharged to generic or specialised services

Abstract

Although the care of forensic patients in the community has been partly taken over by specialist community forensic services (CFS), there are few data assessing their efficacy. The aim of this study was to compare the reconviction rates of patients discharged from a medium secure unit (MSU) either to a specialised community forensic service (CFS) or to a generic service (GS). We compared all patients discharged from Arnold Lodge MSU between 1983 and 2003 to mental health services in Nottinghamshire and Leicestershire, UK, on their rates of reconviction. The clinical and forensic characteristics of the two groups (70 discharged to CFS and 93 to GS) were broadly similar. Median time to reconviction was significantly lower for CFS than for GS (5 and 14+ years respectively, p = .014). Thus, contrary to expectations, patients discharged to the more specialised service had a shorter time to reconviction and this difference could not be explained by the clinical variables measured in the study, other than that those discharged to the CFS had a longer duration of admission at the MSU and were more likely to be on a restriction order.

Keywords:

• medium secure unit
• community forensic service
• reconviction
• outcome