summary
background So far little is known about psychiatric patients who, on committing a crime, are ordered to undergo one year of inpatient treatment due to a hospital order. Such patients seem to be more difficult to treat and cause more incidents on the ward than forensic patients for whom duration of treatment is not set in advance. This may have something to do with the time-limited nature of the hospital order and may also predict the risk of recidivism following discharge.
aim To assess to what extent patients with a one-year hospital order relapse upon discharge and to discover the factors that influence the risk of recidivism.
method Retrospective study based on a Dutch sample of 30 forensic psychiatric patients who had received a one-year hospital order and had completed their treatment in a forensic psychiatric hospital between 2002 and 2005.
results Within four years of their discharge 50% of the research group had relapsed into relatively serious crime, some of them fairly soon after discharge. The recidivism occurred even if the patients continued their treatment upon discharge. This treatment was sometimes provided by the regular psychiatric care services. Recidivists had been sentenced more often in the five years preceding the crime committed upon discharge, had received more psychiatric diagnoses, had obtained higher scores on risk-assessment instruments and had been involved in more incidents during treatment.
conclusion Patients who have received a one-year hospital order often relapse into serious crime, relatively soon after their discharge. One wonders whether the hospital order of one year actually achieves its purpose and whether the mental health services are adequately equipped to supervise these patients after they have completed their compulsory course of hospital treatment.