Women admitted to secure forensic psychiatry services: I. Comparison of women and men

This study compared the demographic and diagnostic characteristics, psychiatric histories and criminal records of female and male patients from a complete sample of Special (high-security) Hospital admissions from all health regions, and medium-security admissions from seven of fourteen regions, in England and Wales from 1988 to 1994. The annual rate of male admissions to the secure specialist services was 5.6 times that for females. Women were admitted more often as transfers from other hospitals, following non-criminalized behavioural disorder, and under the legal category 'Psychopathic Disorder'. Women were also more likely to be charged with or convicted of arson and to have previous histories of fire-setting behaviour. They had fewer previous criminal convictions and more previous psychiatric admissions. They were more likely to receive a primary diagnosis of personality disorder than men, especially borderline personality disorder. These differences suggest that new specialist therapeutic regimes for women are needed. Future research should examine their needs for internal and perimeter security and compare their needs with those of men.