In the UK forensic psychiatric care is provided in 3 different levels of security and patients are expected to progress through this system till rehabilitated. Some patients spend more time than average in secure settings. This group has hitherto been largely neglected within research priorities.

To identify number and characteristics of patients who are “long-stayers” in secure hospitals in the United Kingdom and compare it to other hospitals internationally.

To identify number of patients in secure forensic settings based on various hypothetical cut-offs (time spent in hospital).

To identify patient characteristics.

To compare patient characteristics with those internationally.

Data was collected from 3 high-secure hospitals in the UK along with one medium secure unit with regards to sex, age, date of admission, directorate category and LoS. Descriptive statistics were used to analyse data. Data obtained from 2 units internationally were compared with results from the UK.

Results suggest that mean age of 40 years. the average LoS in high secure hospitals was about 70 months. Around 15% of patients have spent more than 10 years in high secure settings. Average LoS in medium secure was 14 months whilst more than 20% stayed longer than 24 months.

A large proportion of patients spend more than 10 years in high secure hospitals and more than 2 years in medium secure in the United Kingdom. This informs future research in order to identify various patient and system characteristics that prevent them from moving on.