What demands do those admitted from the criminal justice system make on psychiatric beds? Expanding local secure services as a development strategy

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Abstract
The paper reports bed usage over 1 year by patients from the criminal justice system (CJS) in an area with a population of nearly half a million. It includes admissions from the CJS to all levels of security and follows transfers between hospitals. Total bed usage (average occupancy) by cases admitted from the CJS was 17.3 per 100,000, with an approximate cost per annum of £1.4 million per 100,000 population. Cases admitted from the CJS took up 7% of all open bed usage. Of all bed usage by patients from the CJS, 44.8% was in local services, and these cases were responsible for 35.5% of the total costs. Of all secure bed usage 29% was accounted for by cases not originating in the CJS; the figure is 38% if maximum security is excluded. Of all 106 new admissions from courts and remand prisons, 90% were admitted to local psychiatric beds, and 41% of all new admissions were placed in local secure services. It is argued that the results illustrate the value and cost-effectiveness of expanding local forensic services as a strategy for future service development.