Difficult-to-treat and/or dangerous patients are discharged from the hospital by decision of a physician. As concerns patients whose sentences have been waived, a proposal on their discharge is made to the National Supervisory Authority for Welfare and Health (Valvira), which orders the patient to be monitored by a mental health clinic for six months at maximum before being fully discharged from the hospital. During the monitoring period the patient must report to the mental health clinic as agreed; the clinic reports the patient’s status to the hospital. If the patient’s mental well-being deteriorates during the monitoring period, the patient will be transferred back to the hospital for treatment. If there are no difficulties during the monitoring period the patient is discharged from the hospital, transferring responsibility for treatment to outpatient care.
Patients whose sentences have been waived and difficult-to-treat and/or dangerous patients discharged from Niuvanniemi Hospital are generally transferred to psychiatric hospitals of hospital districts, and occasionally to outpatient care. It is generally in the interest of the patients to transfer them to their own hospital, closer to the network and community where they need to manage during outpatient care. The National Supervisory Authority for Welfare and Health also decides on discharge from the patient’s own hospital as concerns patients whose sentences have been waived. A monitoring period may also come into question when discharging a patient from a non-state hospital. Patients transferring directly to outpatient care from the hospital are generally placed in rehabilitation homes or private service homes in their own municipalities. The homes provide a form of housing with support and supervision by mental health professionals. Negotiations regarding outpatient care are also carried out in advance with the patient’s local social welfare and health care authorities. Patients often spend brief evaluation periods at their local psychiatric hospital before decisions on the future treatment location are made.
Mental examination patients are mainly transferred for the examination from prison, where they also return after the examination. Persons to undergo examination arriving from somewhere other than prison return to their original location after the examination; homeless persons will be provided accommodation in their domicile. Mental examination patients for whom treatment is proposed will wait for the decision of the National Supervisory Authority for Welfare and Health at the hospital.