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

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.