Some observations on the supervision of dangerous offender patients.

From time to time, general psychiatrists are asked to supervise offender patients who have been conditionally discharged into the community either by direction of the Home Secretary or by a Mental Health Review Tribunal (Mental Health Act 1983, sections 42(2) and 73(2)(4b)). In addition, they may be asked occasionally to provide psychiatric manage ment for offenders released by the Home Secretary on life licence (Criminal Justice Act 1967, section 61). The effect of a conditional discharge following compulsory admission to hospital care by a court under a restriction order (Mental Health Act 1983, sections 37/41) is similar to that of a life licence. The order for discharge may contain conditions that the individual be supervised by a named person or persons, live in a certain place and under certain conditions, and be subject to any other conditions that are deemed to be conducive to the welfare and management of the offender patient, and to the protection of the public. Conditionally discharged restricted offender patients will normally be supervised by a probation officer or local authority social worker and a psychiatrist. It is very important that these professionals not only maintain regular contact, but also share areas of common concern about their clients/ patients. In some cases, where this has not occurred, there have been unfavourable and sometimes disastrous outcomes: hence the quotation from Wilson. The number of conditionally discharged patients is relatively small in relation to total psychiatric and penal populations, some 600-700 conditionally discharged patients being under active supervision in the country in any year and a slightly smaller number of life licencees (Prins, 1986; Home Office & Department of Health and Social Security, 1987). Although this paper is concerned with conditionally discharged offender patients, the observations can be extrapolated to other situations in which the assessment and management of risk is of paramount consideration (Prins, 1988). The population