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External factors influencing length of stay in forensic services – a European evaluation
 
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1
Warwick Medical School, University of Warwick, Coventry, UK
 
2
Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
 
3
Helsinki University Hospital, Psychiatry, Division of Psychoses and Forensic Psychiatry,Helsinki, Finland
 
4
USL 11 Forensic Unit, Toscana, Italy
 
5
Klinika Psychiatrii Sądowej, Instytut Psychiatrii i Neurologii, Warszawa, Polska
 
 
Submission date: 2018-05-07
 
 
Final revision date: 2018-10-30
 
 
Acceptance date: 2018-10-30
 
 
Online publication date: 2019-06-30
 
 
Publication date: 2019-06-30
 
 
Corresponding author
Paweł Gosek   

Instytut Psychiatrii i Neurologii w Warszawie, Klinika Psychiatrii Sądowej, Sobieskiego 9, 02-957 Warszawa, Polska
 
 
Psychiatr Pol 2019;53(3):673–689
 
KEYWORDS
TOPICS
ABSTRACT
Objectives:
A growing number of patients whose length-of-stay in forensic services is aboveaverage length are identifiable in several European countries. Forensic services are situated within a particular sociocultural setting. Accordingly, this trend to increased admission length cannot be solely attributed to patient characteristics. This is the first known study exploring the influence of external factors on length-of-stay in forensic services.

Methods:
Representatives from 16 European countries, members of the international COST project, focused on forensic psychiatric service, analyzed their respective forensic services using a structured tool. Responses were combined and analyzed using thematic analysis.

Results:
Four themes described the factors influencing length-of-stay: care and treatment pathways; resources; legal and systemic impact; and sharing expertise.

Conclusions:
Findings suggest multidisciplinary consideration of the whole care pathway is required to address increased length-of-stay. Further research is required to support development of evidence-based standards applicable across Europe, and improve outcomes for patients at risk of increased length-of-stay in forensic services.

eISSN:2391-5854
ISSN:0033-2674