Only about 1 in 30 predictions of assault by discharged psychiatric patients will be correct

BMJ 1999;319:1270 ( 6 November )

Letters

Only about 1 in 30 predictions of assault by discharged psychiatric patients will be correct

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EDITOR $---$ The debate about the dangerousness of discharged psychiatric patients is interesting. ¹ ² In public debate (andsometimes also among professionals) it is often claimed that dischargedpatients are responsible for a substantial number of violent assaultsin society. This is sometimes held as a reason for more custodial,institutionalisedtreatment.

In 1987 Wistedt and I studied the possibility of using a prediction of the likelihood of violence, assessed at discharge frominvoluntary psychiatric care, as a means of reducing rates ofviolence in Swedish society.³ Our calculations showed that,at most, 100 serious assaults a year in Sweden were committedby patients who had been discharged during the previous year frominvoluntary psychiatric treatment $---$ that is, less than 1% of allpatients discharged. Trieman et al estimated that 2% of theirpopulation of discharged patients committed serious violent actswithin the five years after discharge (that is, 0.4% a year).²

When . . . [Full text of this article]