Limits to the value of mental health review tribunals for offender patients - Suggestions for reform

Background Reform of mental health legislation for England and Wales is due . MHRTs offer an important check in the balance between patient and public rights. Aims To study the quantity and outcome of MHRTs in special (high-security) hospitals. Method Data were extracted from the records of 1670 patients detained under mental illness or psychopathic disorder classifications in special hospita ls during 1992. Results There were 661 MHRT hearings, mostly requested by patients. Forty-t hree (7%) discharges were ordered, often without key data about continuing care in the written evidence. There were 56 recommendations for transfer to lesser security Correlates of MHRT discharge were: female gender younger a ge (in women), a legal classification of psychopathic disorder and shorter length of stay. Conditional discharge did not necessarily mean departure fr om special hospital. Conclusions Special hospital MHRTs result in few changes in patient status. A probable need for improvement in the evidence put before an MHRT was fou nd. Legislation reformers should consider an extension of MHRT powers to or der transfer between levels of security. Declaration of interest E.G. was funded by the former Special Hospitals' Se rvice Authority and the Broadmoor Hospital Authority.