A Follow-up Interview of Patients Eight Years after Discharge from a Maximum Security Forensic Psychiatry Unit in Norway

Abstract

Research on the fate of patients after discharge from maximum security psychiatric care is scarce. Nonetheless, results indicate that readmission and reconviction rates are unacceptably high. Our research aimed to address three main issues: (1) to report findings from an eightyear follow-up of 125 patients discharged from a maximum security forensic unit (MSU) and to compare the results with studies from other countries; (2) to explore the feasibility and usefulness of face-to-face interviews (N = 38) as compared to using the traditional register-based follow-up method; and (3) to explore differences in psychosocial functioning from discharge to follow-up as a correlate of outcome. Findings replicated results from other research concerning rates of readmission, reconviction, and the strong association between substance abuse and the likelihood of being readmitted to the MSU. Despite methodological limitations, the face-to-face interview appeared to enhance access to significant clinical and psychosocial information. When compared with official records, patients' self-report was reliable for violent crime, not reliable concerning petty crime, and significantly more accurate for crimes pertaining to illegal drugs. Being readmitted to the MSU predicted decreased GAFscore values (OR = −12.89), and living with family predicted increased GAF-score values (OR = 19.20) in the multivariate linear regression analysis.

The National Trajectory Project of Individuals Found Not Criminally Responsible on Account of Mental Disorder in Canada

“…Copyright # 2014 John Wiley & Sons, Ltd. There appears to be dissension in the literature with regard to the rate of success among individuals on community discharge from hospital following a finding of insanity. Riordan, Haque, and Humphreys (2006) asserted that "Conditional discharge for restricted hospital order patients is by and large a successful process" (p. 31); whereas Bjørkly, Sandli, Moger, and Stang (2010) concluded that "Research on the fate of patients after discharge from maximum security psychiatric care is scarce. Nonetheless, results indicate that readmission and reconviction rates are unacceptably high" (p. 343).…”

“…For instance, some studies have examined return to hospital and revocation of CD, while others have used new charges or reconviction as the outcome of interest, and still others focus on violent reoffending. Moreover, firm conclusions are often thwarted by small sample sizes, insufficient duration of follow-up, or reliance on administrative records versus self-report (see Bjørkly et al, 2010). Commentators have also noted that analytical methods vary considerably across studies (Monson, Gunnin, Fogel, & Kyle, 2001).…”

Dynamic and Static Factors Associated with Discharge Dispositions: The National Trajectory Project of Individuals Found Not Criminally Responsible on Account of Mental Disorder (NCRMD) in Canada

“…There appears to be dissension in the literature with regard to the rate of success among individuals on community discharge from hospital following a finding of insanity. Riordan, Haque, and Humphreys () asserted that “Conditional discharge for restricted hospital order patients is by and large a successful process” (p. 31); whereas Bjørkly, Sandli, Moger, and Stang () concluded that “Research on the fate of patients after discharge from maximum security psychiatric care is scarce. Nonetheless, results indicate that readmission and reconviction rates are unacceptably high” (p. 343).…”

“…For instance, some studies have examined return to hospital and revocation of CD, while others have used new charges or reconviction as the outcome of interest, and still others focus on violent reoffending. Moreover, firm conclusions are often thwarted by small sample sizes, insufficient duration of follow‐up, or reliance on administrative records versus self‐report (see Bjørkly et al, ). Commentators have also noted that analytical methods vary considerably across studies (Monson, Gunnin, Fogel, & Kyle, ).…”

Predicting time to recall in patients conditionally released from a secure forensic hospital: A survival analysis

“…Secure psychiatric hospitals, dually tasked with treating 12 forensic psychiatric patients and ensuring public safety, represent 13 a high-cost and low-volume service [1]. Conditionally discharged 14 forensic patients are those who have progressed through forensic 15 inpatient services and been deemed safe to live in the community. 16 Patients are released from secure care on the basis they adhere to 17 specific discharge conditions and formal readmission to a secure 18 hospital (herein referred to as recall) can be enforced should the 19 patient not adhere to these conditions.…”