Research in the U.K. has found that offending by psychiatric patients after discharge is rare. Researchers collected data on all 959 patients discharged from medium secure units in England and Wales between 1997 and 1998 and used the offenders' index to find details of subsequent convictions.
In the two years after discharge, only six percent of psychiatric patients committed a violent offence. The strongest association with offending was previous offending, and substance misuse and sexual abuse were also associated with increased offending risk. Patients were less likely to be convicted after a lengthy admission or if they had a history of self harm. Aftercare was also effective in preventing reconviction.
The authors of the study report that the rate of violent offending is so low that there is little room to reduce it. They contend that it would be better concentrate on the identification of high risk patients.
A prior American study identified a psychopathy "checklist" as the best single predictor of violence in psychiatric patients. The authors of the current study recommend exploring its use in medium security hospitals in England and Wales.
Reference: British Medical Journal, June 2004
