Admissions and discharges from a 30-bed regional secure unit (RSU) were surveyed over a 15-year period. In the last five years there has been a significant increase in the average length of stay of patients and a marked decrease in the number of admissions and discharges. The reasons for this ‘silting up’ of the RSU by longer-term patients and the consequences for an effective forensic psychiatric service are discussed.
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