The decision to release a state patient who is unfit to stand trial and/or not criminally responsible, who had been committed to a mental institution in terms of the Criminal Procedure Act or who was held in terms of section 28 of the Mental Health Act, may have harmful or even fatal consequences. The multi-professional team at Oranje Hospital will only institute discharge procedures regulated in terms of section 29 of the Mental Health Act when it is of the opinion that a state patient's mental illness is stable and well-controlled and his clinical picture is such that he qualifies to be discharged. In this discussion focus will be placed on: a. the two discharge procedures applied in South Africa. b. four case studies which will be presented dealing with the observation period, admission, offence, diagnosis, treatment, hospitalisation, leave periods, discharge on certain conditions, re-admission and further offences. c. the question of whether the State may be held liable for the negligent or wrongful discharge or release of a state patient who subsequently commits a serious crime.