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The British Journal of Psychiatry 175: 313-316 (1999)
© 1999 The Royal College of Psychiatrists

Outcome of admission to a medium secure psychiatric unit. I. Short- and long-term outcome

A Maden, S Rutter, T McClintock, C Friendship and J Gunn
Department of Forensic Psychiatry, Institute of Psychiatry, London.

BACKGROUND: This is the first long-term follow-up of patients discharged from a medium secure unit. AIMS: To describe the short- and long-term outcomes of admission for all patients discharged during a 14- year period. METHOD: A longitudinal cohort study of all 234 patients discharged from the Denis Hill Unit, Bethlem Royal Hospital, between 1980 and 1994, followed for an average 6.6 years. RESULTS: Although 48% of admissions were from prison, only 8% returned there, with most being transferred to another psychiatric bed. One-fifth of patients spent none of the follow-up time in the community; 75% of patients had at least one readmission; only 24% were convicted of further offences. CONCLUSIONS: Re-offending rates are comparable with those for patients discharged from high-security hospitals, and much lower than those for released prisoners. The high readmission rates indicate the need for a range of services to maintain former patients in the community.


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