RESTRICTED HOSPITAL ORDERS - A SURVEY OF FORENSIC PSYCHIATRISTS PRACTICE AND ATTITUDES TO THEIR USE

Forensic psychiatrists throughout mainland UK and Northern Ireland wer e sent a postal questionnaire to determine their practice in cases whe re a restriction order was deemed appropriate and also their attitudes to the use of restricted hospital orders. Data were obtained about th e estimated number of reports completed by each respondent and recomme ndations for restriction orders. In particular, the reasons why a rest ricted hospital order might be recommended or considered appropriate w ere sought. Out of the original sample of 97 psychiatrists, 74 (76%) r eturned completed questionnaires. They had written in excess of 3,000 legal reports in the previous 12 months and 60 (81%) had been involved in cases where a restriction order was considered appropriate in the same period. Of the 74 who responded, 33 (45%) said that they would sp ecify the need for a restriction order when necessary, 27 (36%) stated that they would make no mention of it, and the remainder said that th eir practice would vary. Time-limited orders were not favoured. Some r espondents said they would always recommend a restricted hospital orde r for certain types of offence; 18 (24%) said so for homicide. The maj ority agreed that the most important consideration when making a recom mendation for a restriction order was the fact that it ensured long-te rm follow-up in cases where there was evidence of previous breakdown i n arrangements. The findings strongly suggest that forensic psychiatri sts consider restriction orders a clinically useful tool in some cases rather than primarily a punitive or purely legal instrument.