Schizophrenia in a high-security hospital: long-term forensic, clinical, administrative & social outcomes [2017]

Objective: To determine forensic, clinical, social and administrative outcomes of high-security patients.

Method: Prospective year follow-up study of 169 patients with schizophrenia, 1992–1993.

Results: By the end of the study, 46 (27.2%) patients were in high security, 43 (25.5%) in medium- or low-secure units, 35 (20.7%) in an open ward, 3 (1.8%) in prison and 40 (23.7%) in the community. Violence occurred in 75% of patients over the 10-year follow-up period, and this was serious in 25%. Continuous positive symptoms of psychosis were present in over one-third. One-third had self-harmed during this period but there was only one known suicide and 11 (6.5%) deaths in total. At the end of the study, there was only one person in voluntary employment, 18 (12.7%) living independently and 10 (7.1%) in a relationship. Models were developed to determine factors relevant to these major outcomes.

Conclusions: This is the first study providing comprehensive outcome data over a 10-year period. Forensic services appear good at managing the risk to the community but poor at promoting better social outcomes. The levels of violence within inpatient units are high.

Rajan Darjee, Marianne Øfstegaard & Lindsay Thomson

The Journal of Forensic Psychiatry & Psychology, Volume 28, 2017 – Issue 4