Mr James Mclauchlan1,2,3, Dr Carey Marr1, Professor Richard Kemp2, Professor Kimberlie Dean1,3
1School of Clinical Medicine, University of New South Wales, Kensington, Australia, 2School of Psychology, University of New South Wales, Kensington, Australia, 3Justice Health and Forensic Mental Health Network, Sydney, Australia
Biography:
James is a combined Master of Psychology (Forensic)/PhD candidate at UNSW. His research examines long-term outcomes of discharged forensic patients with a focus on identifying barriers to successful community reintegration. James has clinical experience as a provisional psychologist across the Justice Health and Forensic Mental Health Network, including the Forensic Hospital and adolescent mental health. In 2025, he was awarded the Derek Eaves Research Grant by the International Association for Forensic Mental Health Services. His work integrates clinical and research perspectives with the aim of informing policy and practice at the intersection of mental health and the justice system.
Forensic patients with severe mental illness, such as schizophrenia, pose complex challenges for health and criminal justice systems. Compared to those with schizophrenia without justice involvement, forensic patients are generally more clinically impaired, at greater risk of suicide, and show poor health outcomes after receiving intensive treatment (Landgraf et al., 2013; Uhrskov Sørensen et al., 2020). However, the extant literature on discharged forensic patients has primarily focused on justice-related outcomes and the most recent meta-analysis was conducted over 13 years ago (Fazel et al., 2016). Hence, it remains unclear whether these findings reflect the current challenges forensic patients face in the community.
This presentation reports findings from a meta-analysis examining discharged forensic patient outcomes. The first and second author conducted the systematic review in May 2025 using five databases: PsychINFO, EMBASE, CINAHL, PubMed, Proquest Dissertations & Theses (PROSPERO pre-registration protocol #CRD42024529265). In total, 5362 citations were retrieved and screened, of which 48 eligible studies were included in the meta-analysis. We performed random-effects meta-analyses to obtain pooled incident estimates for six key justice and health outcomes. The overall incidence rate per 100,000 persons-years for violent reoffending, reoffending, reconvictions, readmissions, all-cause mortality, and suicide was reported and compared to the previous estimates. We also examined moderators, including region, publication year, schizophrenia diagnosis, gender, age, and follow-up duration. These findings suggest that forensic patients continue to experience significant health-related harms post-discharge. We will discuss recommendations for forensic patient post-discharge supports to better address these ongoing and unmet needs.