The reconvictions of mentally disordered offenders—how, when, and where?

Abstract

Background Little is known about the recidivism of mentally disordered offenders after discharge from forensic psychiatric services. This is problematic because such knowledge could (i) help professionals who encounter this group to better plan interventions to prevent recidivism, (ii) clarify the rates of recidivism post-discharge from forensic psychiatric care and (iii) further develop instruments for specific risk assessment. The aim of this study was to investigate the new crimes of mentally disordered offenders who had been reconvicted after discharge from forensic psychiatric care. Methods Included in this study were all individuals (n = 1142) who had been discharged from forensic psychiatric care in Sweden during 2009–2018, were included in the Swedish National Forensic Psychiatric Register, and had been reconvicted in a criminal court within the follow-up period of 2009–2018 (n = 157, 14% of the population). The follow-up times of the discharged patients within the period varied from 4 to 3644 days, (m = 1697, Md = 1685). Retrospective registry data along with coded data from criminal court judgments (n = 210) were used to create a database. Kaplan–Meier survival analysis and descriptive statistical analysis was performed. Results 75% of included individuals were reconvicted for at least one violent crime, but only 9 individuals were reconvicted for a serious violent crime, which can be compared to the 44 individuals with serious violent index crimes. The most common crime was “Other violent”. The most common sentence was probation. The offender’s most common relationship to the victim was having no known relationship, followed by the victim being a person of authority. The most common circumstance of the crime leading to the reconviction was that it occurred without apparent provocation; other common circumstances were related to the exercise of public authority. The most common crime scene was a public place. Conclusions Even though the reconvictions of this group included many violent crimes, there were very few serious violent crimes. The findings that the victims of the crimes of mentally disordered offenders are most commonly either unknown to the perpetrator or persons of authority, and that the crimes are often perpetrated without apparent provocation or reason, are important information for all professionals who encounter this group and should be taken into consideration to assess risk more accurately.

Duration of forensic psychiatric care and subsequent criminal recidivism in individuals sentenced in Sweden between 2009 and 2019

“…Another strength of our study is its large sample size and the high coverage of the registries; as such, it can be considered as representative for the contemporary Swedish forensic psychiatric system. Indeed, prior studies focusing on this topic have failed to account for the effect of differences in legal and clinical treatment of mentally ill offenders sentenced in different historical eras ( 13 , 14 ). Here, we decided to restrict our analysis to patients who were sentenced under the current legislation and enrolled in the cohort prospectively, thus making the sample more homogeneous, the results more intuitive and the conclusions more relevant to future deliberations on forensic psychiatric care.…”

“…Two recent studies performed using a Swedish dataset have investigated time estimates for and rates of reconviction after termination of forensic psychiatric treatment, as well as risk factors associated with reconviction, including length of stay, age, and substance misuse ( 13 , 14 ). However, it turns out that these studies have both ignored errors in the registry from which the dataset was derived and failed to exclude individuals who were not included in the dataset prospectively; thus, further studies—in which these errors are amended and the cohort is more stringently defined—are needed.…”

What happens after forensic psychiatric care? A latent class analysis of dimensions of welfare for former forensic psychiatric patients

“…However, there are also alternative interpretations of these results. For example, it is possible that crimes committed by members of this group are not perpetrated mainly towards stranger victims, which is generally the most common for FFPs [29], but toward family members, making it less likely that crime that might occur will be prosecuted and lead to a conviction.…”

“…General risk factors have been shown to predict recidivism, regardless of mental health status [28], which means that FFPs and offenders without mental disorders can be assumed to have some things in common regarding the mechanisms behind (re)offending. This makes the existing literature on what situational aspects matter for recidivism for offenders in general relevant, even if the characteristics of the reoffending of FFPs differ from reoffending in general [29]. Research speci c to this group is therefore warranted.…”

What happens after forensic psychiatric care? A latent class analysis of dimensions of welfare for former forensic psychiatric patients

“…However, there are also alternative interpretations of these results. For example, it is possible that crimes committed by members of this group are not perpetrated mainly towards stranger victims, which is generally the most common for FFPs [ 42 ], but toward family members. This may make it less likely for crimes that occur to be prosecuted and lead to a conviction.…”