Primary objectives: To identify the incidence of head injury (HI) amongst mentally disordered offenders (MDOs) in UK medium secure units (MSUs), and test the hypothesis that patients with a history of HI are more difficult to discharge than patients without HI.\ud Design, methods and procedures: 113 MDOs being discharged to community settings from five MSUs in England were recruited consecutively between 1/4/99 and 31/12/00. Data on previous HI, offending history, and discharge planning were collected from clinical casenotes, structured questionnaires, and interviews with clinical staff.\ud Main outcomes and results: More HI patients (57.4%) than non-HI patients (47%) had a violent index offence. Risk assessments carried out prior to discharge showed HI patients to be at greater risk of violence to others and of self-harm than non-HI patients (p ≤ 0.05). All but two HI patients were difficult to discharge (43, 95.6%), compared to 52 (82.5%) non-HI patients.\ud Conclusions: Information on previous HI should be collected on admission to MSUs and considered when planning for discharge
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