A Re-Conviction Study of Special (High Security) Hospital Patients

Abstract

Reliable patient re-conviction data after leaving high security hospitals are of public interest, but official statistics are without context and sometimes incomplete. Some patient sub-groups are rarely studied. Our study describes re-convictions for a complete national annual high security hospital discharge cohort. We hypothesized that: established community living would precede re-conviction and that more people with personality disorder would be re-convicted, with a higher rate, than people with other disorders, even allowing for community time. Cases were identified using the special hospitals' case register; follow-up data were from multiple records sources. Seventy-four patients (38 per cent) were convicted after discharge, 26 per cent of serious offences. All 10 multiple reoffenders (>9 offences) were men. Fourteen per cent of those re-convicted had offended during institutional residence. Median time to first community re-conviction was under two years. Logistic regression analysis confirmed that people with personality disorder were seven times more likely than people with mental illness to be convicted of a serious offence after discharge. Methodological procedures that maximize validity of findings are discussed.