User, Admission and Discharge Characteristics at Secure Units in Residential Social Care Institutions in Slovenia.

Introduction: To evaluate data on users, the characteristics of admission, placement and discharge of individuals in secure units. These are locked units in special residential institutions in the social care sector. Methods: A total population descriptive study was performed. In April 2024, a questionnaire comprising 72 items was sent to all six institutions with secure units in the field of mental health and intellectual disabilities. Data from 2023 were gathered. Descriptive and univariate analysis were applied. Results: A total of 64% of users were male, and the mean age was 54.3 years. The vast majority of users (98%) were admitted involuntarily and deprived of their legal capacity (67%). The largest proportion of users were admitted following admission into a psychiatric hospital (44%), admission to open units of the same institution (34%) and living in the community (10%). The mean length of stay in the secure unit was 64.01 months. During the placement in secure units, 14% of users were admitted to a psychiatric hospital. Only 17% users were discharged from secure units, with 81% taking place later, while 19% discharges took place before the expiry of a court order. The most common location of discharge was the open unit of the same institution (79%). Conclusions: The results highlight high rates of involuntary admissions, prolonged stays and limited transitions to community care, raising public health and human rights concerns. The findings call for a shift in focus from expanding institutional capacity towards improving discharge practices and strengthening community-based support.