Transfer of Special Hospital Patients to the NHS

Dell, Susanne

doi:10.1192/bjp.136.3.222

Cited by 41 publications

(11 citation statements)

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“…A review of the medium to long term outcomes of discharges from HSPHs in E&W, with follow up between 2-11 years, suggests that hospital readmission rates range between 7 - 22% [19]. Reconviction studies of released HSPH patients also suggest that the rate of serious reconvictions ranges from 3% to 24% overall, [20-22]. However, Davison et al [23] reported that rates were notably higher in patients with a diagnosis of Axis II personality disorder rather than an Axis I disorder.…”

Section: Introductionmentioning

confidence: 99%

The utility of the Historical Clinical Risk -20 Scale as a predictor of outcomes in decisions to transfer patients from high to lower levels of security-A UK perspective

Dolan

Blattner

2010

BMC Psychiatry

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BackgroundStructured Professional Judgment (SPJ) approaches to violence risk assessment are increasingly being adopted into clinical practice in international forensic settings. The aim of this study was to examine the predictive validity of the Historical Clinical Risk -20 (HCR-20) violence risk assessment scale for outcome following transfers from high to medium security in a United Kingdom setting.MethodsThe sample was predominately male and mentally ill and the majority of cases were detained under the criminal section of the Mental Health Act (1986). The HCR-20 was rated based on detailed case file information on 72 cases transferred from high to medium security. Outcomes were examined, independent of risk score, and cases were classed as "success or failure" based on established criteria.ResultsThe mean length of follow up was 6 years. The total HCR-20 score was a robust predictor of failure at lower levels of security and return to high security. The Clinical and Risk management items contributed most to predictive accuracy.ConclusionsAlthough the HCR-20 was designed as a violence risk prediction tool our findings suggest it has potential utility in decisions to transfer patients from high to lower levels of security.

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Section: Introductionmentioning

confidence: 99%

The utility of the Historical Clinical Risk -20 Scale as a predictor of outcomes in decisions to transfer patients from high to lower levels of security-A UK perspective

Dolan

Blattner

2010

BMC Psychiatry

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“…Bowden (1981) reported in a review of studies of discharges from high security with followup between 2-11 years that readmission rates ranged between 7%-22%. Studies reporting on re-offending behaviour suggest that the rate of serious reconvictions ranges between 3% to 30% (Black and Spinks, 1977;Dell, 1980;Tennent and Way, 1984;Bailey and MacCulloch, 1992), but Davison et al (1999) noted that rates were notably higher in patients previously detained under the legal category of psychopathic disorder (PD).…”

Section: Introductionmentioning

confidence: 99%

Outcome of high security patients admitted to a medium secure unit: the Edenfield Centre study

Blattner

Dolan

2009

Med Sci Law

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Blattner and Dolan: Outcome of high security patients admitted to a medium secure unit 247 ABSTRACT This study examined the outcome of a cohort of 72 patients from a high secure psychiatric hospital (HSPH) who were admitted to and discharged from the Edenfield Centre over a 16-year period. The sample was predominately male and mentally ill and the majority was subject to restriction orders. Compared with two similar studies focusing specifically on the outcomes of HSPH patients in medium security, our sample had fewer women and the group had more extensive criminal and psychiatric histories. None of our cohort was discharged to the community via district services or transferred to other hospitals. We found that the Edenfield Centre had relatively higher rates of readmissions to the HSPH and a slightly higher reconviction rate than similar studies focusing solely on the outcomes of HSPH patients. In line with previous research, those detained under the legal category of psychopathic disorder were more likely to be reconvicted following discharge to the community than those detained under mental illness. Further large scale studies are needed to compare the outcomes of HSPH patients discharged through medium secure services that operate parallel or integrated aftercare service models.

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“…This, as Susanne Dell (1980) has shown, has to an important extent been due to a hardening of the attitudes of the psychiatric services to Special Hospital patients. The present study demonstrates that Broadmoor's patients are now staying longer in conditions of maximum security than their pre decessors, and it is the firm opinion of Broadmoor con sultants that this is unjustifiable on clinical grounds.…”

Section: Resultsmentioning

confidence: 99%