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There is an increasing trend for patients detained in medium secure units (MSUs) to stay for longer than 2 years. Little information is currently available on factors which determine prolonged stay. The study aimed to identify characteristics associated with prolonged length of stay in a MSU in East London. Stay for more than 2 years was associated with diagnosis of psychotic disorder, multiple previous admissions, detention under a hospital order, being on a restriction order, and a history of moderately violent offending. Factors indicating risk of future violence were not found to be associated with length of admission. Beds in this MSU were blocked by a cohort of patients with specific clinical characteristics and needs, indicating that reconfiguration of services is required to provide rehabilitation at lower levels of security. [ABSTRACT FROM AUTHOR]

Mentally incapacitated individuals represent a vulnerable section of our society. The law has been involved in making decisions for adults lacking capacity for several centuries. While children lacking capacity usually have the safeguard of parents who can make decisions on their behalf, adults incapacitated, often due to mental disorder or physical illness, have been left largely in the hands of professionals. The concept of treating an incapacitated adult in their 'best interests' has arisen in the Courts and statute relatively recently. This article will explore the introduction of the concept of best interests, how this concept has been developed primarily through case law, and the more recent impact of Parliamentary statute in helping define this term. [ABSTRACT FROM AUTHOR]