Circumstances Leading to and Characteristics of Belgian Forensic Patients Remitted to Prison

Abstract

In Belgium, when forensic patients infringe their conditional release, they are remitted to prison. Given the poor conditions of detention and the current lack of alternatives, revoking conditional releases has a high impact. However, little is known about which patients are remitted to prison and why. In this article, we compared a sample of remitted patients (n ¼ 50) to a matched control group (n ¼ 48). We found that patients with high actuarial risk factors (as assessed by the Violent Risk Appraisal Guide, VRAG), antisocial personality disorder traits (measured by the Comprehensive Assessment of Psychopathic Personality, CAPP), and substance abuse disorder were more likely to be remitted. New acts of violence and substance abuse are the most prevalent reasons for revoking a conditional release, at 71% and 65%, respectively. The current results are independent of living conditions, and highlight the need for future research regarding this subgroup of forensic patients, who are more likely to be set back in their rehabilitative processes.

Characteristics of People Returned to Prison From Medium Secure Psychiatric Services in England and Wales: National Cohort Study

“…At 224 days (IQR = 426), median length of stay was below the recommended stay of 18 months to 2 years ( 14 ) and length of stay for prison remittals was significantly shorter (median = 173.5 days, IQR = 367) than for community discharges (Median = 404.0 days, IQR = 830) u = 1,423.0, p < 0.001 ( Table 2 ). Most patients stayed in medium secure services <2 years ( n = 116, 82%), although those remitted to prison were 66% less likely to be have been admitted for “24 months plus” (10 vs. 33%, P =.001).…”

“…The nexus between the criminal justice system and mental health services differs internationally and, at present, there is little work conducted into understanding the remittal care pathway outside of England and Wales. We are aware a recent body of work in Belgium which sought to understand circumstances by which people are returned to prison from secure psychiatric services ( 13 , 14 ). In this investigation it was observed that all returns to prison were on the basis of the individual subverting security.…”

“…This included: threats of violence; physical violence; instigation of a riot; criminal recidivism; drug trafficking, and bullying and harassment. A further study observed that remitted patients had significantly a significantly higher instance of traits of psychopathy and substance use problems, alongside significantly more static and dynamic risk factors for violence at time of remittal as compared to those who remained detained in the MSS (14). These findings suggest that remittal of patients who are "high risk" is a clinical practice that is not unique to England and Wales.…”