{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T14:38:03Z","timestamp":1772807883028,"version":"3.50.1"},"reference-count":14,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":5541,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In the UK, people with mental disorder thought to pose a high risk of harm to others are usually put in a high-security (special) hospital. Little is known about what happens after that.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To test a hypothesis that, under current services and laws (from the mid-1980s), no one leaving high-security hospitals remains indefinitely institutionalised.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The special hospitals' case register was used for case ascertainment and admission data; post-discharge data were collected from multiple sources on patients discharged in 1984 (census date 31.12.1995).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this discharge cohort (<jats:italic>n<\/jats:italic>=223), 36 (17%) did not return to the community: 17 died in special hospital and 19 continuously lived in other institutions until death or the census date. Over two-thirds of these had mental illness, were older on admission and had lived longer in special hospital than their better-rehabilitated peers. Offending history was irrelevant to this. Most post-discharge institution time was in open psychiatric hospital, or back in special hospital, not in medium secure units or prison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The hypothesis was not sustained, but fewer people never reached the community than before the mid-1980s. Atypical antipsychotics might reduce this number. We found no justification for a new tier of long-term medium secure units.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.181.5.399","type":"journal-article","created":{"date-parts":[[2002,10,31]],"date-time":"2002-10-31T17:49:50Z","timestamp":1036086590000},"page":"399-405","source":"Crossref","is-referenced-by-count":9,"title":["Mental disorder and perceived threat to the public: people who do not return to community living"],"prefix":"10.1192","volume":"181","author":[{"given":"Liz","family":"Jamieson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela J.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2018,1,2]]},"reference":[{"key":"S0007125000268955_ref8","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.165.2.160"},{"key":"S0007125000268955_ref7","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.176.3.253"},{"key":"S0007125000268955_ref4","doi-asserted-by":"publisher","DOI":"10.1080\/09585189308407789"},{"key":"S0007125000268955_ref1","doi-asserted-by":"publisher","DOI":"10.1080\/09585189208407628"},{"key":"S0007125000268955_ref2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.172.6.472"},{"key":"S0007125000268955_ref3","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.176.3.260"},{"key":"S0007125000268955_ref6","volume-title":"Report of the Committee on Mentally Abnormal Offenders","year":"1975"},{"key":"S0007125000268955_ref9","volume-title":"Integration of Special Hospital Patients into the Community","author":"Norris","year":"1984"},{"key":"S0007125000268955_ref11","volume-title":"Stata Statistical Software. 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