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Patients were on average 34 years of age and had spent 9 years in psychiatric hospitals. Seventy percent had a diagnosis of schizophrenia and a quarter had a primary or secondary diagnosis of antisocial personality disorder. Approximately half were admitted following an offence and over 80% had a history of criminal activity. Physical health problems were present in more than 50% of patients. Many had experienced adverse events in childhood. Psychotic symptoms, seriously disturbed behaviour and instances of self-harm continued to occur in many patients despite extensive treatment. Over half were said not to require the full security of the State Hospital and lack of adequate local facilities was the commonest reason given for failure to transfer them elsewhere. Predictive factors for admission to the State Hospital for patients with schizophrenia at the time of their first psychiatric admission included male gender, younger age at first hospital admission, greater chronic physical ill health, poorer educational attainment and more substance abuse in first degree realties. A greater criminological history, poorer educational attainment, longer hospital stays but fewer admissions, and more lifetime symptoms of psychosis were predictive factors at the time of admission. Predictors of admission to the State Hospital for people with learning disability were substance abuse, previous self-harm and single martial status. For the co-morbid learning disability and schizophrenic cohort these were earlier age of first hospital admission, no family history of either condition, a history of cerebral insult, and male gender. The State Hospital population increased from 200 patients in 1993 to 242 in 1998. A comparison of the trends seen in the mental health and criminal justice systems with trends in the State Hospital population indicates a relationship between the two, particularly changes in the number of drug related crimes and in the number of available psychiatric beds. |
