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There is an increasing trend for patients detained in medium secure units (MSUs) to stay for longer than 2 years. Little information is currently available on factors which determine prolonged stay. The study aimed to identify characteristics associated with prolonged length of stay in a MSU in East London. Stay for more than 2 years was associated with diagnosis of psychotic disorder, multiple previous admissions, detention under a hospital order, being on a restriction order, and a history of moderately violent offending. Factors indicating risk of future violence were not found to be associated with length of admission. Beds in this MSU were blocked by a cohort of patients with specific clinical characteristics and needs, indicating that reconfiguration of services is required to provide rehabilitation at lower levels of security.
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