There is a large population (n =389) of insanity acquittees on monitored conditional release in Oregon. This article focuses on the living situation for these individuals, which can range from a secure residential treatment facility to independent living. This article will define all the different placement options available and then review the current living situation for all conditionally released insanity acquittees in the state of Oregon on a single day, February 1, 2014. This article shows that the majority of individuals on conditional release live in the most highly structured settings available. The article then ends with a discussion of these findings, including a comparison of current placement options, with previous descriptions in the literature demonstrating that current community options offer more structure and more individuals reside in structured settings than was previously the case. Current findings will be related to inpatient psychiatric bed reduction strategies and the question of possible transinstitutionalization.

Between January 1, 2012 and December 31, 2014, there was a large population (N = 200) of insanity acquittees placed on conditional release (CR) in the state of Oregon. This article looks at the demographic and system characteristics of this large group of individuals. The authors then focus on the initial housing placement and what happens to individuals after their release in relation to their housing placement. In Oregon, insanity acquittees are either conditionally released directly by the court or placed in the hospital prior to potential CR by a supervising board. In general, once CR occurs, individuals tend to stay in their initial placement without moving to less structured levels of care, raising concerns about transinstitutionalization. This is especially true for individuals released to the most structured living arrangement (secure residential treatment facility). Those individuals who are conditionally released to less structured settings have a higher rate of revocation back to the hospital. Those individuals who do move to less structured levels of care usually have longer hospital stays and start off in more structured levels of care to start their CR. Copyright © 2016 John Wiley & Sons, Ltd.