Professionals’ needs and decisions regarding long-term TBS patients in Dutch forensic care

• In Event: Deciding on (long-term) forensic care in the Netherlands

Abstract

Most long-term TBS patients are placed either in a Long-Term Forensic Psychiatric Care (LFPC) facility or longcare units. For the LFPZ facility, an official status is required. Additionally this status is reviewed every two years to assess whether continued stay is necessary and appropriate. In contrast, longcare units lack an official legal status or formalized policy framework, Despite these policy differences, the distinction between these two types of care is not always clear. Both LFPC and longcare facilities have seen high admission rates in recent years, leading to increased waiting lists. The aim of this study was therefore twofold: first, to provide an overview of the needs of long-term TBS patients and professionals related to care, policies and legal status. Second, a qualitative vignette study was used to map the decision-making process of these professionals regarding placement of a patient either in the LFPC or a longcare unit.
In an interview study 43 professionals related to long-term TBS patients and 23 patients were interviewed. The vignette study was incorporated in the interviews among the professionals who are occupied with placement decisions.
The interviews provide an overview of the experiences and needs of patients and professionals associated with long-term TBS patients in Dutch forensic care. The vignette study showed that professionals’ decisions mostly rely on treatment factors and development of risk behaviors. They encounter practical problems with capacity and policy.
These results emphasize that long-term TBS patients are very similar in terms of characteristics but their behavior distinguishes them between longcare and LFPC units. However, current systemic problems underscore the need for a critical evaluation of current systems as well as further collaboration within the long-term tbs system to further improve care for these individuals.

Authors

• Roosmarijn van Es, Leiden University

• Michiel van der Wolf, University of Groningen

• Joni Reef, Leiden University

• Eleni Georgaki, Leiden University

• Sanne Ritzema, Leiden University