Detention in Broadmoor

Abstract

When the length of stay of restricted patients admitted to Broadmoor under the legal category of psychopathic disorder was examined, the factor found to be of primary importance was the gravity of the admission offence. If the men's offences did not cause personal injury, they had a good chance of early release. Patients convicted of violent or sexual offences, and particularly those who attacked strangers, made up the great majority of the long-term group. For the mentally ill there was no relationship between length of stay and admission offence: instead the data suggested that severity and chronicity of illness were the main relevant factors.

A mixed-methods study exploring the characteristics and needs of long-stay patients in high and medium secure settings in England: implications for service organisation

“…However, a number of studies have demonstrated that this LoS is far exceeded in a large proportion of cases (see literature review in Chapter 4). For high secure care, earlier studies have identified an average LoS of about 8 years 33 but, again, no shared standard exists as to from what LoS onwards individuals should be considered 'long-stay patients'.…”

“…37,84,88,97 Two UK studies had samples drawn from a women's medium secure unit. 40,87 An earlier UK study of Broadmoor high secure patients by Dell et al 33 used an 8-year threshold, the authors observing that 53% of those with a 'psychopathic disorder' and 42% of those with a 'mental illness' classification of the (then) MHA were 'long-termers' who were detained for > 8 years. A threshold of 10 years was used in Germany by Ross et al, 93 who found that 15% of their sample had a LoS that exceeded 120 months.…”

“…12,26,28,29,33,34,37,[39][40][41][42]57,74, Eleven countries were represented: the UK (n = 22 12,26,28,29,33,34,37,39-42,77-80, 82,84,86,87,89,92,97 ), the USA (n = 4 90,94,96,99 ), Ireland (n = 2 81,98 ), Germany [n = 2 93 (one of which was personal communication: Dönisch-Seidel, Ministerium für Gesundheit, Emanzipation, Pflege und Alter des Landes Nordrhein-Westfalen, 2013)], Croatia (n = 2 57,88 ), Australia (n = 1 85 ), Malaysia (n = 1 83 ), New Zealand (n = 1 95 ), Norway (n = 1 91 ), the Netherlands (n = 1 74 ) and Sweden (n = 1 76 ). The studies from the UK had samples drawn from high secure (n = 5 29,33,78,84,89 ), medium secure (n = 14 26,37,[39][40][41][42]77,79,80,82,86,87,92,97 ) and mixed secure (n = 3 12,28,34 ) settings. The Norwegian study was based in a 'maximum' secure setting.…”

“…One early study at Broadmoor Hospital 33 identified severity of index offence as the most important factor for personality disordered patients, while for those with mental illness, psychopathology was a more relevant predictor of LoS. Studies in medium secure settings have identified severity of psychopathology, psychiatric history, seriousness of offending, patients being on 'restriction orders' (requiring Ministry of Justice permission for transfer), non-engagement in interventions, dependency needs and lack of step-down facilities as factors associated with long stay.…”

“…These were published between 1987 and 2015 with samples covering the period from 1972 to 2011. Five countries were represented: the UK (n = 12 12,26,28,33,34,[39][40][41][42]82,92,97 ), Germany (n = 1 93 ), the USA (n = 1 99 ), Malaysia (n = 1 83 ) and Ireland (n = 1 98 ). Thirteen studies supplied LoS as a mean value; only five provided medians, which are arguably a better measure of central dispersion for a variable that commonly has a non-normal ('skewed') distribution.…”