Tully et al raise important questions about the introduction of electronic monitoring of forensic patients. ^{Reference Tully, Hearn and Fahy1} Incidents of absconding by forensic patients can give rise to calls for increased security and surveillance. As the authors point out, adoption of electronic monitoring as a panacea for these problems is short-sighted. Tully et al cover many of the concerns about electronic monitoring but one area is missing: that the evidence we have from electronic monitoring in the criminal justice sector is primarily of its effects on recidivism and absence without leave during use; evidence is very limited on the effects after its use.

In other words, electronic monitoring must eventually cease. Is the use of electronic monitoring during community reintegration actually preparing the patient for greater freedom and their rehabilitation, or simply delaying reoffending? Criminal justice experience with electronic monitoring focuses almost entirely on its effectiveness during use, such as on bail or as an alternative to incarceration, usually combined with home detention. Electronic monitoring combined with home detention is superior to imprisonment in these studies, but we already know that non-custodial responses to crime in general have superior outcomes to incarceration (see, for example, Wermink et al ^{Reference Wermink, Blokland, Nieuwbeerta, Nagin and Tollenaar2} ).

We know very little about outcomes after the use of electronic monitoring. Although the use of global positioning satellite (GPS) technology might improve the person’s performance in following rules, it is not clear that this sort of rule following encourages the person in the ultimate tasks of forensic rehabilitation. Does it improve the therapeutic alliance to help the person make the life changes necessary to recover from illness and illness-related offending? Or does electronic monitoring seem a physical manifestation of distrust and create distance between the patient and the treatment team? If the only way that a person can safely have community contact is to wear an ankle bracelet, isn’t it questionable whether they are ready for that level of community contact? Electronic monitoring may allow the person more apparent personal freedom than their clinical risk would otherwise allow. As Tully et al point out, adoption of the GPS technology may seem appealing, but its costs and effects are not clear and neither is its impact on therapeutic and community engagement. Short-term reductions in absence without leave might give the appearance of progress that the patient has not actually achieved. Long-term outcome is equally as important as short-term adherence.