Mentally disordered offenders who are born abroad: pathway of care through medium secure services

Recent changes in UK immigration policy have led to increasing deportation of foreign national offenders and more than 5000 were deported in 2008. This rise follows a review in 2006 which found that some foreign national offenders were being lost due to disposal or transfer through mental health services. As a result, a department was set up within the United Kingdom Border Agency (UKBA) to identify and review those detained under Restrictions Orders who were due to be conditionally released from hospital, so that they could be considered for deportation. As a result of these changes, forensic clinicians are more frequently presented with detained patients who have immigration problems that can lead to problems in the care pathway through secure services. A local audit was carried out in an inner‐London medium secure service to quantify the number of detained patients who are born abroad, and to review their care pathways to determine whether they are affected by immigration difficulties. It is hoped that the discussion of the issues identified by this audit can support service improvement and provide better care for patients in medium secure services.