ZusammenfassungIm vorliegenden systematischen Review werden Faktoren zusammengetragen, welche den Erfolg der Legalbewährung bei entlassenen Patienten des Maßregelvollzugs (§§ 63 und 64 StGB) positiv oder negativ beeinflussen können. Als Ergebnis einer Literaturrecherche konnten 7 häufig untersuchte Bereiche identifiziert werden: Wohnumgebung, Erwerbstätigkeit, Familie/Partnerschaft, Freizeit/soziale Kontakte, Substanzkonsum, Nachsorge und psychologische Variablen. Aus den Ergebnissen wurden, wo möglich, Daten zur Quantifizierung von Größe und Richtung der Effekte berechnet. Diese zeigen für Patienten des psychiatrischen Maßregelvollzugs ein erhöhtes Rückfallrisiko bei Substanzmissbrauch und häufigem Wechsel von Wohnort und Arbeitsplatz. Protektiv wirken dagegen ein psychisch stabiler Zustand und ein zumindest während der ersten Zeit nach der Entlassung institutionalisiertes Wohnumfeld. Für Patienten, die nach § 64 StGB untergebracht sind, können keine eindeutigen Aussagen getroffen werden. Auch hier scheint jedoch erneuter Suchtmittelkonsum das Risiko für Rückfälle zu erhöhen.

Surveys and questionnaires are widely used in various areas of psychological and psychiatric research and practice. Many instruments have been used in several languages and across cultural contexts. A popular method of choice for their translation into another language involves translation and back-translation. Unfortunately, this method’s ability to detect flaws in translation and necessities for cultural adaptation is limited. To address these shortcomings, the Translation, Review, Adjudication, Pretest, and Documentation (TRAPD) approach of questionnaire translation from cross-cultural survey design has been developed. In this approach, several translators with different professional backgrounds translate the questionnaire on their own first and then come together to discuss their versions. Since the translators’ expertise is required to vary (e.g., survey methodology experts, translation experts, expert knowledge in the questionnaire’s topic) the team approach results in a high-quality translation as well as offering opportunities for cultural adaptation. This article illustrates the application of the TRAPD approach on the basis of the translation process of the Forensic Restrictiveness Questionnaire from English into German. Differences and advantages are discussed.

In Germany, the most frequently used legal section to order forensic mental health treatment is § 63 of the Penal Code (Strafgesetzbuch; StGB). This disposition is primarily aimed at individuals with major mental illnesses who are not fully responsible for a criminal act they committed. Despite evaluation and follow-up studies being conducted within individual hospitals or federal states we lack key epidemiological data on this patient group across the whole country. The present study aims to fill this gap by conducting an annual survey of all eligible forensic mental health hospitals to develop a database of basic clinical, legal and demographic data. Staff at participating hospitals will complete an online survey answering questions about individual patients using routinely collected hospital records. Over the duration of the study, eight-and-a-half years, we aim to collect data on approximately N = 6,450 patients. Alongside important clinical data, we will use official reconviction data at 3- and 6-year follow-ups to investigate the number and types of crimes committed by discharged patients. We aim to extend the scientific literature on factors associated with reconviction in the Risk-Needs-Responsivity model by also measuring the extent to which treatment engagement and programme completion during care predicts reconviction. This study protocol describes the background and theoretical framework for this study, its methods of data collection and analysis, and steps taken to ensure compliance with ethical and data protection principles.

Introduction A feeling of restrictiveness is often associated with coercive practices, such as seclusion or restraint. In addition to these obvious procedures more subtle practices can also feel restrictive. Its registration and monitoring is of special importance in forensic mental health care since feelings of restrictiveness can lead to adverse events like increased aggression and suicidal intentions. Objectives To enable the registration of the experience of restrictiveness in forensic mental health settings in Germany, the Forensic Restrictiveness Questionnaire was translated from English into German. Methods Method: We used the TRAPD approach presented by Harkness (2003). This approach combined the expertise of professional translators and clinical experts and enabled adaptation at an early stage. The developed version underwent a cognitive pretest with a small patient sample to check for comprehensibility and interpretation of the questions in line with the original authors intention. Results A preliminary translation of the FRQ was developed. Translators combined their expertise from linguistic and clinical practice as well as their knowledge about English and German culture to produce a translation as close as possible to the original questionnaire with necessary adaptations. Remaining uncertainties, e.g., regarding comprehensibility of long phrases or uniform interpretation of certain wordings or questions, were addressed in the cognitive pretest with patients. The version produced can be used for validation. Conclusions Conclusion: The TRAPD approach produced a comprehensible and well adapted German translation of the FRQ. This version underwent a cognitive pretest by a small patient sample and is now ready for validation. Disclosure No significant relationships.

Experienced Involvement (also called Peer Support Work, PSW) has existed in mental health care in Germany since 2005 though its implementation lags behind, compared to other countries. Due to the unique challenges of forensic-psychiatric settings, implementation of PSW in these settings is even less developed. We prepared the implementation of a peer support worker in our forensic hospital for addicted offenders in Germany in several steps: A survey amongst the 75 forensic hospitals in Germany was conducted to evaluate the prevalence of PSW in these settings. Individual interviews were conducted with directors and peer support workers of forensic clinics nation-wide to investigate their facilities’ experiences with PSW. Focus groups with several occupational groups of the clinic in Rostock addressed staffs opinions, expectations and reservations regarding peer support work. These were recorded and transcribed for thematic analysis. Results: revealed that the majority of forensic hospitals (83.6%) has no experience with peer support work. Interviews with external clinic directors revealed similar concerns and expectations among the employees as our focus groups did. Staff at the clinics expected the peer support worker to offer useful experiences and new perspectives. Concerns occurred about stability of health condition of the peer support worker, trust issues because of former criminal behavior and attitudes towards psychiatric treatment that might interfere with professional treatment negatively. Furthermore the clinic directors stressed the importance of a well prepared implementation and a good “fit” of the peer support workers background to the patients (e.g. regarding diagnosis).DisclosureNo significant relationships.