Medium secure units: pathways of care and time to discharge over a four-year period in South London

We studied the predictors of length of hospital stay in medium secure hospital beds among 157 male patients discharged from medium secure beds in two London boroughs between 2002 and 2006. Patients who were subject to Section 37/41 restriction stayed in medium secure care on average 483 days longer than those under civil sections or transferred from prison (p=.001). Those under Section 37/41 had a significantly longer length of stay than those under Section 37 or Section 3 (p.05). Those on restriction orders were significantly more likely to be discharged to a supported hostel than those in the civil/prison group (p=.008). Overall demand for hostel placements was high. The findings of this study suggest that those patients in medium secure units on Section 37/41 restriction orders will have longer admission times and are more likely to be discharged into supported mental health hostels. More research is needed to establish a link between delayed discharges for those under Section 37/41 in medium secure units and lack of supported mental health hostel beds in the community.