Patterns and Correlates of Inpatient, Emergency and Ambulatory Mental Health Service Contact for Forensic Patients Found Not Guilty by Reason of Mental Illness (NGMI) After Discharge from Secure Care

Rates of reoffending among forensic patients discharged from secure hospital care are known to be low, but comparatively little is known about contact with health services after discharge. This study describes the patterns and correlates of health service contact among discharged Forensic Patients in New South Wales (NSW), Australia. Records of Emergency Department (ED) presentations, hospital admissions, and ambulatory mental health care were linked to the records of the 227 Forensic Patients. Two thirds of the sample had contact with ambulatory mental health services within a month of discharge, and most (81.5%) presented to an ED or were admitted to a hospital during the study period. Factors associated with earlier hospital contact included being of English-speaking background, anti-social personality traits, and having a non-homicide related index offence. Predictors of ambulatory mental health contact within one month included prior contact with mental health services, non-homicide related index offence, prior criminal charges, and co-morbid substance use disorder. Early and continued engagement with community mental health services is an important component of community forensic mental health care. The high rate of hospital admission in the sample may reflect the assertive follow-up received by most Forensic Patients through proactive engagement with mental health services and the low tolerance for signs of relapse.