The British Journal of Psychiatry
Discharges to prison from medium secure psychiatric units in England and Wales
Michael Doyle, Jeremy Coid, Laura Archer-Power, Lindsay Dewa, Alice Hunter-Didrichsen, Rachel Stevenson, Verity Wainwright, Costas Kallis, Simone Ullrich, Jenny Shaw
  • Declaration of interests




Early findings from a national study of discharges from 32 National Health Service medium secure units revealed that nearly twice as many patients than expected were discharged back to prison.


To compare the characteristics of those discharged back to prison with those discharged to the community, and consider the implications for ongoing care and risk.


Prospective cohort follow-up design. All forensic patients discharged from 32 medium secure units across England and Wales over a 12-month period were identified. Those discharged to prison were compared with those who were discharged to the community.


Nearly half of the individuals discharged to prison were diagnosed with a serious mental illness and over a third with schizophrenia. They were a higher risk, more likely to have a personality disorder, more symptomatic and less motivated than those discharged to the community.


Findings suggest that alternative models of prison mental healthcare should be considered to reduce risks to the patient and the public.

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