Reconviction of special (high security) hospital patients with personality disorder: its relationship with route of discharge and time at risk

Background Few follow-up studies of mentally disordered offenders have taken into account time spent in the community at risk of reoffending when calculating reconviction rates. Method This small exploratory study examined the effect of discharge destination (community or hospital) on reconviction over a nine-year period in an annual discharge cohort (1984) of special hospital patients with personality disorder, controlling for time spent ‘at risk’ in the community. Results Those discharged directly to the community spent significantly more time at risk in the community during follow-up but they were no more likely to be reconvicted than those discharged via a less secure hospital. Discussion One possible explanation is that less secure hospital units are not specifically equipped to treat people with a personality disorder. Alternatively, clinicians may be correctly identifying patients who are at greater risk of reoffending and thus recommending a more staged rehabilitation back to the community. It was apparent that there are very few official data available about placements following absolute discharge. The implications for this and other studies of this type are discussed