National policy in England is now directed towards keeping patients with intellectual disability (ID) presenting with forensic problems for time-limited treatment. The result is that secure hospital services are expected to work much more proactively to discharge patients to community-based services. However, there is little evidence in recent years on the outcome of discharged patients with ID from secure hospitals. The purpose of this paper is to describe the outcomes of a patient group discharged from a specialist forensic ID service in London, England.,This is a descriptive retrospective case note study of patients with ID admitted to and discharged from a secure service with both low and medium secure wards, over a six-year period from 2009 to 2016. The study examined patient demographic, clinical and outcome variables, including length of stay, pharmacological treatment on admission and discharge, offending history and readmissions to hospital and reoffending following discharge.,The study identified 40 male patients, 29 of which were admitted to the medium secure ward. In all, 27 patients (67.5 per cent) were discharged into the community with 14 patients having sole support from the community ID services and 4 from the community forensic services. In total, 20 per cent of patients were readmitted within the study period and 22.2 per cent of patients received further convictions via the Criminal Justice System following discharge.,This was a complex group of patients with ID discharged into the community with a number at risk of requiring readmission and of reoffending. Community-based services providing for offenders with ID must have sufficient expertise and resourcing to manage the needs of such a patient group including the ongoing management of risks. The national drive is significantly to reduce the availability of specialist inpatient services for this group of patients but this must occur alongside an increase in both resources and expertise within community services.

中文翻译：

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内城法医智障服务的成果

英格兰的国家政策目前旨在使智障患者出现法医问题，以进行限时治疗。结果是，安全的医院服务有望更加主动地开展工作，以使患者接受社区服务。但是，近年来，很少有证据表明从安全的医院出院的ID病人的结局。本文的目的是描述从英国伦敦的专业法医身份证服务出院的患者群体的结局。从2009年到2016年的六年期间，对中型和中型病房进行了研究。该研究调查了患者的人口统计学，临床和结局变量，包括住院时间，出院时的药理治疗，有病史和再次入院以及出院后再次出院。该研究确定了40例男性患者，其中29例入了中等安全病房。总共有27名患者（67.5％）出院，其中14名患者在社区ID服务的唯一支持下，有4名在社区法医服务的支持下。总共有20％的患者在研究期内重新入院，而22.2％的患者出院后通过刑事司法系统被进一步定罪。这是一类复杂的ID出院患者，其出院风险​​很高需要重新录取和重新冒犯。为具有身份证明的罪犯提供的基于社区的服务必须具有足够的专业知识和资源，才能管理此类患者群体的需求，包括持续的风险管理。全国性的推动力是大大减少这类患者的专业住院服务，但这必须与社区服务中资源和专业知识的增加同时进行。