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Readmission after discharge from a medium secure unit

  • Martin Clarke (a1), Conor Duggan (a2), Clive R. Hollin (a3), Nick Huband (a4), Lucy McCarthy (a5) and Steffan Davies (a6)...
Abstract
Aims and method

We examined readmission to psychiatric hospital of 550 patients discharged from one medium secure unit over 20 years. Multiple sources were used to obtain readmission data.

Results

Readmission was common, particularly to non-secure psychiatric hospitals. At least 339 patients (61.6%) were readmitted to any psychiatric hospital (mean follow-up 9.5 years), with over a third (37.6%) subsequently being readmitted to medium- or high-security or both. Of those discharged directly to the community, having previous in-patient treatment and a Mental Health Act classification of mental illness were associated with shorter time to first readmission.

Clinical implications

The long-standing nature of disorders is evident in the high rates of readmission overall and the need for readmission to medium and high secure services, suggesting that these patients require long-term follow-up and support from mental health services.

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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
Martin Clarke (drmartinclarke@googlemail.com)
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Declaration of interest

None.

Footnotes
References
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1 Friendship, C, McClintock, T, Rutter, S, Maden, A. Re-offending: patients discharged from a Regional Secure Unit. Crim Behav Ment Health 1999; 9: 226–36.
2 Edwards, J, Steed, P, Murray, K. Clinical and forensic outcome 2 years and 5 years after admission to a medium secure unit. J Forensic Psychiatry 2002; 13: 6887.
3 Falla, S, Sugarman, P, Roberts, L. Reconviction after discharge from a regional secure unit. Med Sci Law 2000; 40: 156–7.
4 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 Gray, NS, Snowden, RJ, MacCulloch, S, Phillips, H, Taylor, J, MacCulloch, MJ. Relative efficacy of criminological, clinical, and personality measures of future risk of offending in mentally disordered offenders: a comparative study of HCR-20, PCL:SV, and OGRS. J Consult Clin Psychol 2004; 72: 523–30.
6 Maden, A, Rutter, S, McClintock, T, Friendship, C, Gunn, J. Outcome of admission to a medium secure psychiatric unit. I. Short- and long-term outcome. Br J Psychiatry 1999; 175: 313–6.
7 Baxter, R, Rabe-Hesketh, S, Parrott, J. Characteristics, needs and reoffending in a group of patients with schizophrenia formerly treated in medium security. J Forensic Psychiatry 1999; 10: 6983.
8 Dolan, M, Khawaja, A. The HCR-20 and post-discharge outcome in male patients discharged from medium security in the UK. Aggress Behav 2004; 30: 469–83.
9 Maden, A, Skapinakis, P, Lewis, G, Scott, F, Burnett, R, Jamieson, E. Gender differences in reoffending after discharge from medium-secure units. National cohort study in England and Wales. Br J Psychiatry 2006; 189: 168–72.
10 Davies, S, Clarke, M, Hollin, C, Duggan, C. Long-term outcomes after discharge from medium secure care: a cause for concern. Br J Psychiatry 2007; 191: 70–4.
11 Clarke, M, Davies, S, Hollin, C, Duggan, C. Long-term suicide risk in forensic psychiatric patients. Arch Suicide Res 2011; 15: 1628.
12 Sahota, S, Davies, S, Duggan, C, Clarke, M, Huband, N, Owen, V. Women admitted to medium secure care: their admission characteristics and outcome as compared with men. Int J Forensic Ment Health 2010; 9: 110–7.
13 Ricketts, D, Carnell, H, Davies, S, Kaul, A, Duggan, C. First admissions to a regional secure unit over a 16-year period: changes in demographic and service characteristics. J Forensic Psychiatry 2001; 12: 7889.
14 Gibbon, S, Huband, N, Bujkiewicz, S, Hollin, C, Clarke, M, Davies, S, et al. The influence of admission characteristics on outcome: evidence from a medium secure forensic cohort. Personal Ment Health 2013; 7: 110.
15 Davies, S. Compulsory treatment in the community: current legal powers. Adv Psychiatr Treat 2002; 8: 180–8.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Readmission after discharge from a medium secure unit

  • Martin Clarke (a1), Conor Duggan (a2), Clive R. Hollin (a3), Nick Huband (a4), Lucy McCarthy (a5) and Steffan Davies (a6)...
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