One of the programming concerns is the fact that the disturbed violent offender does not fit well into the contemporary hospital setting. Offenders cannot leave the hospital until they are determined to be no longer dangerous, even if they are no longer considered disturbed. They readily admit that this is not a simple distinction, as there are no clear lines drawn between rehabilitation and mental health services. The differentiation of offenders into homogeneous groups allows for the creation of a therapeutic community for offenders with similar problems. Toch and Adams also advocate a special setting for troubled or disturbed inmates within the prison environment.
Autonomy introduces flexibility and allows for some relaxation of routines if necessary.
The authors believe there is a need for experimentation with interface arrangements such as those proposed in this study. The disturbed violent offender requires interdisciplinary attention and interagency collaboration. Above all, institutions must provide programming and services that are sensitive to the complexity of individuals. Further research is needed to develop models that respond to the multiproblem offender. The work of Toch and Adams should stimulate more interest in this exciting and relatively unexplored area.