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In Germany, the Forensic Hospital in Haina/Germany has a tradition of more than two decades of continuously outpatient treatment of mentally ill offenders. In our system, patients were conditionally released after a successful hospital order treatment. Time under parole for these patients normally spread between two to five years. In nower days, after a reform of penal law, time under parole can be unlimited. Since 1988 far more than 1000 patients were released from the forensic hospital and treated under parole conditions in the community. The paper will describe the careers of these patients, demonstrate rates of success and failure, and explain our treatment and risk-management approach. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess the potential for future violent behaviour comparing patients recruited from forensic and general psychiatric wards in Germany., Patients and Methods: Fifty patients were recruited from a forensic hospital and 29 from a general psychiatric hospital. In the weeks preceding discharge, structured assessments of the future risk of violent behaviour were completed using the HCR-20., Results: There was little difference in the risk presented by the two groups. Forensic patients presented an elevated risk of violence because of historical factors, while the risk among patients from general psychiatry was due to clinical symptoms., Conclusion: Some criminal offences could be prevented if more time and effort were spent in general psychiatric practice in identifying patients at high risk for violence and in reducing symptoms of psychoses before discharge.

The analysis of 11 cases of violent offenses committed during hospital order treatment in the Haina Forensic Psychiatric Hospital between 1985 and 1991 showed that biographical and forensic variables are more powerful predictors of dangerousness than treatment and psychopathological data. In more than half of these cases it was at least questionable whether the individuals had been placed correctly inside the hospital order system. In comparison to data found in inmate populations and a new study from North America the question arises as to whether the treatment might not have contributed to increase dangerousness in at least some of our cases.