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Article
Publication date: 1 January 2025

Lena Boons, Petra Habets, Leen Cappon and Steven Degrauwe

In Belgium, mentally ill offenders often spend extended periods in forensic psychiatric hospitals, where restrictive living conditions can affect their quality of life (QoL). QoL…

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Abstract

Purpose

In Belgium, mentally ill offenders often spend extended periods in forensic psychiatric hospitals, where restrictive living conditions can affect their quality of life (QoL). QoL is a key factor in these settings, influencing both short- and long-term recidivism risks. Despite its significance, research on QoL in Belgian forensic psychiatry is scarce. Internationally, studies highlight that the sexuality domain tends to score lower than other QoL areas. This study aims to explore QoL in forensic psychiatry with a particular focus on the sexuality domain.

Design/methodology/approach

This cross-sectional, observational study involved 275 male forensic psychiatric patients, all found not guilty by reason of insanity and under court-ordered psychiatric treatment. Patients resided in either treatment units or long-term forensic care units. Data were analyzed using R Studio.

Findings

Patients in medium-security units in Flanders reported the lowest satisfaction in the sexuality domain compared to other QoL areas. Additionally, overall QoL declined with longer stays in forensic psychiatric care.

Practical implications

The study underscores the need for clear policies regarding sexuality in forensic psychiatric settings. Integrating sexuality and sexual health assessments into routine evaluations is recommended. Future research should explore long-term QoL changes while investigating the impact of sexuality policies and considering gender and cultural differences. Collaboration between forensic institutions is key to improving data collection, while staff training on addressing sexuality is essential. Including patients in policy development and promoting their sexual health rights will help create a more inclusive environment.

Originality/value

To the best of the authors’ knowledge, this is the first study to pool data from three forensic medium-security units in Flanders, providing new insights into QoL in Belgian forensic psychiatry.

Details

The Journal of Forensic Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 13 March 2019

Petra Habets, Inge Jeandarme and Harry G. Kennedy

Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Research regarding the assessment of security…

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Abstract

Purpose

Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Research regarding the assessment of security level is minimal and few instruments are available. The DUNDRUM toolkit is a structured clinical judgement instrument that can be used to provide support when determining security level. The purpose of this paper is to investigate the applicability and validity of the DUNDRUM-1 in Flanders.

Design/methodology/approach

The DUNDRUM-1 was scored for 50 male patients admitted at the forensic units in the public psychiatric hospital Rekem. Some files were rated by three researchers who were blind to participants’ security status, resulting in 33 double measurements.

Findings

Almost all files (96 per cent) contained enough information to score the DUNDRUM-1. Average DUNDRUM-1 final judgement scores were concordant with a medium security profile. No difference was found between the current security levels and the DUNDRUM-1 final judgement scores. Inter-rater reliability was excellent for the DUNDRUM-1 final judgement scores. On item level, all items had excellent to good inter-rater reliability with the exception of one item institutional behaviour which had an average inter-rater reliability.

Practical implications

The DUNDRUM-1 can be a useful tool in Flemish forensic settings. It has good psychometric properties. More research is needed to investigate the relationship between DUNDRUM-1 scores and security level decisions by the courts.

Originality/value

This is the first study that investigated the applicability of the DUNDRUM-1 in a Belgian setting, also a relative large number of repeated measurements were available to investigate the inter-rater reliability of the DUNDRUM-1.

Details

Journal of Forensic Practice, vol. 21 no. 1
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 2 September 2014

Wouter Stassen, Petra Habets, Astrid Mertens, Jan De laender and Inge Jeandarme

In Belgium approximately a quarter of forensic psychiatric patients reside within penitentiaries instead of treatment facilities. This situation has yielded the Belgian government…

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Abstract

Purpose

In Belgium approximately a quarter of forensic psychiatric patients reside within penitentiaries instead of treatment facilities. This situation has yielded the Belgian government several convictions from the Human Rights Court in Strasbourg. In an attempt to facilitate admissions from penitentiary to psychiatric hospital, the Forensic Department of the psychiatric hospital in Rekem (OPZC Rekem), has piloted the InReach project. The paper aims to discuss these issues.

Design/methodology/approach

The objective of this project is to engage a psychiatric nurse on the ward in pretherapeutic and motivational activities on a regular basis in the penitentiary for vulnerable groups of forensic psychiatric patients, forming a bridge between penitentiary and hospital. The InReach project even considers patients who have no desire to leave the penitentiary (e.g. due to their psychiatric profile). A motivational approach is used to support these patients in making the transition from penitentiary to hospital.

Findings

The current article describes the focus of the InReach project (procedures and InReach candidate profiles) together with the first impressions of the progress that has been made by the InReach project. In addition two case studies of InReach patients are presented. The InReach project is clearly needed in Belgium and because of its success it has been extended to another penitentiary. It is probable the two other medium-security wards will also be included in the project in the near future.

Originality/value

The Belgian government has received several convictions from the Human Rights Court in Strasbourg because a substantial number of forensic psychiatric patients reside within penitentiaries instead of treatment facilities. The InReach project presented in this paper is clearly needed in Belgium and was implemented to initiate and facilitate the transition from penitentiaries to treatment facilities. The need for this type of project is reflected in the number of forensic psychiatric patients that reside within a penitentiary and that are not able or willing to make the transition to a treatment facility because of their psychiatric profile.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 35 no. 3
Type: Research Article
ISSN: 0964-1866

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