Schizophrenia in a high-security hospital: long-term forensic, clinical, administrative & social outcomes. Issue 4 (4th July 2017)

• Record Type: Journal Article
• Authors: Darjee, Rajan; Øfstegaard, Marianne; Thomson, Lindsay
• Is Part Of: Journal of forensic psychiatry & psychology. Volume 28:Issue 4(2017)
• Page Start: 525
• Page End: 547
• Publication Date: 2017-07-04
• Subjects: Schizophrenia -- outcomes -- high security -- mentally disordered offenders; Forensic psychiatry -- Periodicals; Forensic psychology -- Periodicals; 614.1
• DOI: 10.1080/14789949.2017.1308537
• Languages: English
• ISSNs: 1478-9949

Abstract

Abstract: 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.