Outcome of admission to a medium secure psychiatric unit

Maden, Anthony; Friendship, Caroline; McClintock, Tom; Rutter, S.

doi:10.1192/bjp.175.4.317

Cited by 50 publications

(83 citation statements)

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“…That study also found that 50 former patients (21%) spent some of the follow-up period in a high secure hospital, including 27 patients discharged directly to such hospitals. 6 A high rate of readmission to any hospital was also shown in another, albeit smaller, medium secure unit cohort of 63 former patients with schizophrenia, with 56 (89%) patients requiring at least one readmission to a psychiatric hospital (mean follow-up 5.4 years), of whom 41 (73%) had multiple readmissions. 7 A large survey of all medium secure units in England and Wales found a readmission rate of 27% for women and 21% for men within 1 year.…”

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confidence: 72%

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Readmission after discharge from a medium secure unit

et al. 2013

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Aims and methodWe examined readmission to psychiatric hospital of 550 patients discharged from one medium secure unit over 20 years. Multiple sources were used to obtain readmission data.ResultsReadmission was common, particularly to non-secure psychiatric hospitals. At least 339 patients (61.6%) were readmitted to any psychiatric hospital (mean follow-up 9.5 years), with over a third (37.6%) subsequently being readmitted to medium- or high-security or both. Of those discharged directly to the community, having previous in-patient treatment and a Mental Health Act classification of mental illness were associated with shorter time to first readmission.Clinical implicationsThe long-standing nature of disorders is evident in the high rates of readmission overall and the need for readmission to medium and high secure services, suggesting that these patients require long-term follow-up and support from mental health services.

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confidence: 72%

“…6 Other variables such as age, gender and number of convictions were not associated with readmission. That study also found that 50 former patients (21%) spent some of the follow-up period in a high secure hospital, including 27 patients discharged directly to such hospitals.…”

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confidence: 92%

Readmission after discharge from a medium secure unit

et al. 2013

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“…Despite the availability of many descriptive studies on psychiatric hospitalizations [11][12][13][14][15][16][17][18] few have worked with large and representative samples collected from large regions involving more than one hospitalization unit, [19][20][21] thus providing a more encompassing view of the mental health network.…”

Section: Discussionmentioning

confidence: 99%

Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution

Barros

Marques

Carlotti

et al. 2009

Rev. Bras. Psiquiatr.

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Objective: Characterize and compare acute psychiatric admissions to the psychiatric wards of a general hospital (22 beds), a psychiatric hospital (80) and of an emergency psychiatry unit (6). Method: Survey of the ratios and shares of the demographic, diagnostic and hospitalization variables involved in all acute admissions registered in a catchment area in Brazil between 1998 and 2004. Results: From the 11,208 admissions, 47.8% of the patients were admitted to a psychiatric hospital and 14.1% to a general hospital. The emergency psychiatry unit accounted for 38.1% of all admissions during the period, with a higher variability in occupancy rate and bed turnover during the years. Around 80% of the hospital stays lasted less than 20 days and in almost half of these cases, patients were discharged in 2 days. Although the total number of admissions remained stable during the years, in 2004, a 30% increase was seen compared to 2003. In 2004, bed turnover and occupancy rate at the emergency psychiatry unit increased. Conclusion:The increase in the number of psychiatric admissions in 2004 could be attributed to a lack of new community-based services available in the area beginning in 1998. Changes in the health care network did affect the emergency psychiatric service and the limitations of the community-based network could influence the rate of psychiatric admissions. Descriptors

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“…In several Western countries, the average duration a patient stays in highly secure forensic settings has been rising (Andreasson et al, 2014;Davoren et al, 2012;Margetić, Margetić, & Ivanec, 2014;O'Neill et al, 2003;Ross, Querengässer, Fontao, & Hoffmann, 2012;Shah, Waldron, Boast, Coid, & Ullrich, 2011;Sharma et al, 2015). Two decades ago researchers in the UK reported mean LOS in medium security was less than 2 years (Maden, Friendship, McClintock, & Rutter, 1999;McKenna, 1996). In 2002, a UK study showed that mean LOS exceeds 5 years for about 10% of forensic psychiatric patients (Edwards, Steed, & Murray, 2002).…”

Section: Introductionmentioning

confidence: 99%

Patient characteristics related to length of stay in Dutch forensic psychiatric care

Eckert¹,

Schel²,

Kennedy

et al. 2017

The Journal of Forensic Psychiatry & Psychology

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Create an overview of characteristics of patients in long-term forensic psychiatric care (LFPC) with a higher length of stay (LOS) care compared to patients in regular forensic psychiatric care (RFPC) with a shorter LOS. Data were collected from 139 patient records. This study examined whether patients in LFPC differ from patients in RFPC on sociodemographic data, legal data and clinical data and whether those characteristics are able to predict LOS. Patients in LFPC were more often born in a Dutch Caribbean country, less often had a substance abuse disorder, were more often emotionally neglected during childhood, had a higher HCR-20 risk item score, a higher security needs score, a higher (less successful) recovery score, were more often recidivist and had absconded more often than RFPC patients. Certain characteristics were able to distinguish the longer LOS group which might be useful to establish sequel services and enhance treatment efficiency.

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Outcome of admission to a medium secure psychiatric unit

Abstract: The higher rate of admission of African-Caribbean patients is consistent with a higher level of demand. There is a need for studies of the pathways by which patients from ethnic minorities reach medium-security accommodation, with a view to early intervention.

Cited by 50 publications

References 15 publications

Readmission after discharge from a medium secure unit

Readmission after discharge from a medium secure unit

Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution

Patient characteristics related to length of stay in Dutch forensic psychiatric care

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