A descriptive analysis of incidents of absconding and escape from the English high-security hospitals, 1989–94

In the present climate of risk assessment and management which is necessarily universal in the provision of services for mentally disordered offenders, incidents of absconding and escape from high-security hospitals pose a significant threat, not only to those directly involved in the incident. The literature on factors associated with 'unauthorized absence' from 'open' psychiatric institutions is of relatively little assistance in informing risk decisions in high-security hospitals, since a number of the criteria for admission to hospitals with high walls are precisely those that predict increased risk of absconding from other services. With the benefit of hindsight, a description of the behaviour of 45 patients who were involved in 43 incidents of unauthorized absence from the three English high-security hospitals between 1989 and 1994 is outlined, with the aim of disseminating information about patterns within and across incidents that might be associated with different levels of risk to the patient(s), the hospital and the public.