Crushed by the Belgian system: Lived experiences of forensic care trajectories by persons labelled as not criminally responsible

Pau, Marjolein De; Mertens, Anouk; Bourmorck, Delphine; Vanderplasschen, Wouter; Nicaise, Pablo; Laenen, Freya Vander

doi:10.1016/j.ijlp.2019.101539

Cited by 9 publications

(21 citation statements)

References 27 publications

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“…exception of those detained or under a compulsory placement order, MDOs are requested to apply to access care services on their own; services are free to accept or refuse the application, and the application must then be approved by the court. This procedure slows down access to services further reduces the number of available places (De Pau et al, 2020). The fact that, within the Belgian healthcare system, services, including in forensic psychiatry, have extensive autonomy to decide and apply their own inclusion and exclusion criteria (Nicaise et al, 2014(Nicaise et al, , 2020 makes the design of a consistent care trajectory more complex.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, guidelines and procedures for referrals between services are needed. Those guidelines should take into account the security needs of MDOs as well as their experience and expectations in relation to their care pathway and social reintegration (De Pau et al, 2020). The definition of objectives and the process of a full care trajectory oriented toward person-centered care in forensic psychiatry still need to be developed (V€ ollm et al, 2018a).…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with this legal measure, MDOs are asked to develop their own care project, which must include an application for a psychiatric care service chosen by the MDO, with support from the psychosocial service of the prison or residential care service where they reside. Although this measure may appear very person-centered, that aspect is counterbalanced by organizational factors (Aga et al, 2020;De Pau et al, 2020). The application has to be accepted by the service that is applied for (based on the service's own inclusion and exclusion criteria) and then approved by a specific court, named the "Chambre de Protection Sociale"/"Kamer voor de Bescherming van de Maatschappij" (Chamber for the Protection of Society), which is made up of justice and care experts.…”

Section: Introductionmentioning

confidence: 99%

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Are Mentally Disordered Offenders Admitted to Appropriate Secure Settings according to Security Needs? A Cross Sectional Study in Belgium

Nicaise

Bourmorck

Pau

et al. 2022

International Journal of Forensic Mental Health

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Mentally Disordered Offenders (MDOs) who have been declared not criminally responsible for their offense due to their mental condition should be admitted to settings with lowest possible level of security to support their social reintegration. In the context of the reorganization of care for MDOs in Belgium, we assessed the predictors and retrospective appropriateness of 3529 MDO admissions in 2017 according to security needs. Although there was a positive association between the security needs of MDOs and the level of security of the settings to which they were admitted, there was a gap between high and lower security levels. Medium-security settings made up 46% of all admissions, covering a variety of security need profiles. Half the sample of MDOs with high security needs was found in low-and medium-security settings, while a significant proportion of MDOs with low security needs was found in medium-security settings. Clinical characteristics predicted admissions more strongly than custodial characteristics. Decision-makers should refine criteria and procedures for MDOs' care access. Indeed, the mixed results in relation to admission appropriateness in medium-security services may result from the lack of formal guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Are Mentally Disordered Offenders Admitted to Appropriate Secure Settings according to Security Needs? A Cross Sectional Study in Belgium

Nicaise

Bourmorck

Pau

et al. 2022

International Journal of Forensic Mental Health

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“…This study follows a similar study design as that of De Pau et al ( 29 ) to maximize the comparability of the findings. The target population in this study are family members of PNCR who are currently residing in a high-, medium- or low-secure setting [cf.…”

Section: Methodsmentioning

confidence: 99%

“…For example, they often feel they do not have a voice in the decisions made concerning their trajectory, which is contradictory to the empowerment principle of recovery. In addition, due to in- and exclusion criteria in forensic services PNCR are regularly deprived of the (specialized) care they need ( 29 , 30 ). Perspectives of family members are only rarely addressed within forensic recovery literature ( 28 ).…”

Section: Introductionmentioning

confidence: 99%

Voices to be heard: Understanding family perspectives in forensic care trajectories

et al. 2022

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IntroductionDe-institutionalization of psychiatric care has greatly increased the role of family members in the recovery pathways of Persons labeled as Not Criminally Responsible (PNCR). However, the role of family members in supporting PNCR in forensic psychiatric care remains understudied. Scarce evidence indicates that PNCR have to deal with stigma and endure specific burdens (i.e., symptom-specific, financial, social, and emotional). Recovery-focused research showed that recovery in both persons with a severe mental illness and family members develop in parallel with each other and are characterized by similar helpful principles (e.g., hope and coping skills). As such, the recovery pathways of PNCR often goes hand in hand with the recovery pathway of their family members. During the family recovery process, family members often experience not being listened to or being empowered by professionals or not being involved in the decision-making process in the care trajectory of their relative. Therefore, the aim of this study is to capture how family members experience the care trajectories of their relatives, more specifically by looking at family recovery aspects and personal advocacy of family members.MethodsSemi-structured interviews were conducted with 21 family members of PNCR from 14 families. A thematic analysis confirms that family members suffer from stigma and worry significantly about the future of their relative.ResultsRegarding the care trajectory of PNCR, family members experienced barriers in multiple domains while trying to support their relative: involvement in care and information sharing, visiting procedures, transitions between wards, and the psychiatric and judicial reporting by professionals. In addition, family members emphasized the importance of (social) support for themselves during the forensic psychiatric care trajectories and of a shared partnership.DiscussionThese findings tie in with procedural justice theory as a precondition for family support and family recovery within forensic psychiatric care.

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Hospital break. An eight-year review of escapes and absconds from two high security forensic centers

Jeandarme

Vandenbosch²,

Boucké³

et al. 2023

International Journal of Law and Psychiatry

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Crushed by the Belgian system: Lived experiences of forensic care trajectories by persons labelled as not criminally responsible

Cited by 9 publications

References 27 publications

Are Mentally Disordered Offenders Admitted to Appropriate Secure Settings according to Security Needs? A Cross Sectional Study in Belgium

Are Mentally Disordered Offenders Admitted to Appropriate Secure Settings according to Security Needs? A Cross Sectional Study in Belgium

Voices to be heard: Understanding family perspectives in forensic care trajectories

Hospital break. An eight-year review of escapes and absconds from two high security forensic centers

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