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Escapes and absconding from secure psychiatric units

  • Tim Exworthy (a1) (a2) and Simon Wilson (a2) (a3)
Summary

A prominent radio news programme reported on escapes from secure psychiatric units in the UK and linked that with subsequent offending by psychiatric patients. The report cited did not distinguish between escapes and absconding but, it is argued here, these are very different activities. The acceptable rate both for escapes and absconding from secure psychiatric units is not defined. A certain level of absconding is a consequence of the therapeutic use of leave, which, as part of rehabilitation, is likely to be linked with a reduced reoffending rate post-discharge.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Tim Exworthy (tim.exworthy@kcl.ac.uk)
Footnotes
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We requested clarification on these points from the BBC Radio 4 Today programme, but have never received a response.

Declaration of interest

Both authors work at low secure psychiatric units.

Footnotes
References
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1 Booth, J, de Bruxelles, S. Security fears as 116 mentally ill criminals escape in a year. Times Online 2008; 9 September (http://www.timesonline.co.uk/tol/news/uk/health/article4714143.ece).
2 Ministry of Justice. Offender management caseload statistics 2006. Statistical Bulletin 2007 (http://www.justice.gov.uk/publications/offender-management-caseload-stats-2006.htm).
3 Kennedy, HG. Therapeutic uses of security: mapping forensic mental health services by stratifying risk. Adv Psychiatr Treat 2002; 8: 433–43.
4 Exworthy, T, Gunn, J. Taking another tilt at high secure hospitals. The Tilt Report and its consequences for secure psychiatric services. Br J Psychiatry 2003; 182: 469–71.
5 Gradillas, V, Williams, A, Walsh, E, Fahy, T. Do forensic psychiatric inpatient units pose a risk to local communities? J Forens Psychiatry Psychol 2007; 18: 261–5.
6 Adshead, G. Three degrees of security: attachment and forensic institutions. Crim Behav Ment Health 2002; 12 (2 suppl): S3145.
7 Scott, PD. Punishment or treatment: prison or hospital? BMJ 1970; 2: 167–9.
8 Maden, A, Scott, F, Burnett, R, Lewis, GH, Skapinakis, P. Offending in psychiatric patients after discharge from medium secure units: prospective national cohort study. BMJ 2004; 328: 1534–5.
9 National Offender Management Service. Offender Management Caseload Statistics 2004, England and Wales. Home Office, 2005.
10 National Patient Safety Agency. Never Events. Framework 2009/10. Process and Action for Primary Care Trusts 2009/10. National Reporting and Learning Service, National Patient Safety Agency, 2009.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Escapes and absconding from secure psychiatric units

  • Tim Exworthy (a1) (a2) and Simon Wilson (a2) (a3)
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