The powers of discharge for the mentally ill offenders come from the Home Secretary under the Mental Health Act, section 42 and from the Mental Health Review Tribunal (MHRT). Guidelines for professionals issued by the Department of Health and the Home Office prepare the offender patient for discharge usually to an ordinary psychiatric hospital or to a medium security facility as part of a process of transition into society. Clinical management requires good multidisciplinary team work with removal of established and entrenched territorial traditions. Attention to details, original offense, prior convictions, and an ability to exercise intrusive supervision and good counseling skills are important attributes for the supervisor together with knowledge about varieties of mental disorders. In addition, the social and psychiatric supervisor needs to understand his or her motivation for working with this group of people who have committed horrible and bizarre crimes. 16 references