Abstract
How should we judge a readmission to high secure psychiatric services? A case‐by‐case view is insufficient to make sense of potential service deficiencies. People in high secure psychiatric settings more often than not test our services and cause considerable alarm. The local clinical response is to seek to improve the condition, and they enter the high secure service. The political, legal and clinical imperatives ensure that patients return just as soon as they are ‘fit’. This paper details the career paths of 11 ‘readmissions’ to Ashworth Hospital, now part of Mersey Care NHS Trust, and suggests that it is more a question of tackling gaps in our combined services than of ascribing individual failings.
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