Route of discharge for special (high-security) hospital patients with personality disorder

BACKGROUND: A considerable proportion of patients with personality disorder are discharged directly to the community from special (high-security) hospitals. AIMS: To examine whether patients with personality disorder discharged directly to the community are more likely to be re-convicted than those transferred to psychiatric hospitals of lesser security. METHOD: Re-conviction data for a five- to nine-year follow-up were collected for a four-year (1988-1991) special hospital discharge cohort of patients with personality disorder. RESULTS: Individuals discharged directly to the community were not significantly more likely to be re-convicted than those transferred to less secure psychiatric hospitals. However, patients discharged to the community without formal conditions of supervision were more likely to be re-convicted than those discharged to the community with conditions or those transferred to other psychiatric hospitals. CONCLUSIONS: Formal supervision after discharge may be more important than actual destination in influencing the likelihood of re-conviction.