Intended for healthcare professionals


High security facilities must not be closed until viable alternatives are in place

BMJ 1999; 319 doi: (Published 03 July 1999) Cite this as: BMJ 1999;319:59
  1. Kapil Sayal, Specialist registrar (,
  2. Anthony Maden, Senior lecturer
  1. Maudsley Hospital, London SE5 8AF
  2. Department of Forensic Psychiatry, Institute of Psychiatry, London SE5 8AZ

    EDITOR—The future of special hospitals, including the possibility of closure, has been much debated.1 2 Although it is assumed that up to one third of the current 1400 patients could be managed in long term medium security,3 most of the research underpinning this assumption may be out of date.4 Special hospitals have tightened their admission criteria and have fewer elderly patients than they used to; these patients have been replaced by younger and more dangerous patients. …

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