Admissions to a national forensic hospital 1997-2003

Objectives: We set out to review all admissions from the criminal justice system to the Central Mental Hospital from January 1997 to December 2003, with particular attention to patient diagnoses, offences, source of admission, length of stay, and patterns of discharge. This study was undertaken to assist with future service planning and determination of resource needs.Methods: The service maintains a combination of electronic and handwritten records of all admissions. Information was extracted concerning all admissions from January 1, 1997 to December 30, 2003. The data was analysed using a statistical package, SPSS 11.0 for Windows.Results: Nine hundred and eighty-six admissions of 780 individuals from the criminal justice system were recorded from January 1997 to December 2003. There has been an increase in the proportion of patients admitted suffering with severe mental illness. There has also been a significant shift in the pattern of discharges, with a higher proportion of patients leaving to return to their local hospital. The proportion of admissions returned to prison has fallen from 91.1 % in 1999 to 64.7% in 2003, while 3.3% of individuals admitted became new long-stay cases.Conclusions: A shift in the profile of patients admitted in recent years reflects changes within the National Forensic Mental Health Service. An increased provision of regular and structured psychiatric input to the prisons has facilitated the identification of prisoners with mental illness. The shift from prison liaison to diversion from the Criminal Justice System to mental health services is however in its early stages.