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Admission trends to a special hospital: court diversion and prison transfers.

This paper reviews the literature regarding the diversion of mentally disordered offenders from the criminal justice system to the mental health services, with a specific focus on the high security psychiatric special hospitals. The traditional sources of admission to these institutions have been predominantly courts and prisons, with the majority of patients being admitted via the former route. This study reports on the admissions to a special hospital over a 20-year period, and shows that over the previous decade there has been a reversal in this trend, with the number of patients transferred from prison being greater than that via any other route. The factors that may have contributed to this reversal are discussed and conclusions are drawn as to the external and internal forensic factors that may influence the court's decision in the referral process.