Abstract
For the majority of high secure patients, discharge is a necessary part of treatment and rehabilitation, and a goal of the care pathway. Patients are very rarely released straight back into the community; instead the majority progress to a Medium Secure Unit (MSU) (Adshead, Charles, & Pyszora, 2005). Offender patient narratives suggest mixed feelings of ambivalence, uncertainty and anxiety towards the prospect of discharge to lower security settings (Maine & Gudjonsson, 2005; Pescosolido, Wright & Lutfey, 1999) with reported problems of being labelled as a high security offender patient; removal of former high secure privileges and difficulties in developing new therapeutic alliances (Skelly; 1994), that in some cases lead to acting out for the purposes of facilitating a return to high security. The Leavers Group delivered at the Centralised Groupwork Services, Broadmoor hospital, was established on the basis the leaving process may be stressful and complex, particularly for patients for whom leaving high security may mean leaving the first secure base they have ever had and a community in which they are known and taken seriously (Adshead et al., 2005). The group was set up to give patients the opportunity to think about the leaving experience and benefit from being with patients going through the same transition. The current study aimed to investigate group membership, why patients would be referred and the progress of group graduates who have been discharged compared to those that did not attend the Leavers group.