Improving continuity of forensic mental health care

Abstract

Purpose Continuity of forensic mental health care is important in building protective structures around a patient and has been shown to decrease risks of relapse. Realising continuity can be complicated due to restrictions from finances or legislation and difficulties in collaboration between settings. In the Netherlands, several programs have been developed to improve continuity of forensic care. It is unknown whether professionals and clients are sufficiently aware of these programs. The paper aims to discuss this issue. Design/methodology/approach The experienced difficulties and needs of professionals and patients regarding continuity of forensic care were explored by means of an online survey and focus groups. The survey was completed by 318 professionals. Two focus groups with professionals (15 participants), one focus group and one interview with patients (six participants) were conducted. Findings The overall majority (85.6 percent) reported to experience problems in continuity on a frequent basis. The three main problems are: first, limited capacity for discharge from inpatient to outpatient or sheltered living; second, collaboration between forensic and regular mental health care; and, third, limited capacity for long-term inpatient care. Only a quarter of the participants knew the existing programs. Actual implementation of these programs was even lower (3.9 percent). The top three of professionals’ needs are: better collaboration; higher capacity; more knowledge about rules and regulation. Participants of the focus groups emphasized the importance of transparent communication, timely discharge planning and education. Practical implications Gathering best practices about regional collaboration networks and developing a blueprint based on the best practices could be helpful in improving collaboration between setting in the forensic field. In addition, more use of systematic discharge planning is needed to improve continuity in forensic mental health care. It is important to communicate in an honest, transparent way to clients about their forensic mental health trajectories, even if there are setbacks or delays. More emphasis needs to be placed on communicating and implementing policy programs in daily practice and more education about legislation is needed Structured evaluations of programs aiming to improve continuity of forensic mental health care are highly needed. Originality/value Policy programs hardly reach professionals. Professionals see improvements in collaboration as top priority. Patients emphasize the human approach and transparent communication.

“The moment he realized he needed our joint assistance made the difference”: a multiple case study into working elements in the supervision of probation clients with debt

“…The present study shows that professionals and clients especially experience close collaboration with other professionals, such as debt counselors, as an important working element. The observed importance of collaboration is in line with studies showing that good collaboration between organizations positively influences the reintegration process of clients and strengthens the continuity of care (de Vogel et al , 2019). Based on a literature review, Bosker et al (2020) defined the following effective elements of collaboration in probation supervision, in line with the current case study: proximity, such as by working from the same building, a shared vision on practices with and around the client between professionals from different organizations, exchanging information and a clear division of tasks between professionals from different organizations, mutual respect and equal collaboration, involving more expertise and faster access to necessary services of care, continuity of the program in and after incarceration and organizational preconditions facilitating collaboration, such as time and size of caseload, policy, work processes and administration.…”

How to Assist Probationers with Debt Problems during Supervision? A Qualitative Study into the Experiences of Both Probation Officers and Clients

“…The results implicate that systematic collaboration with other professionals and organizations is necessary for probation officers, especially with specialists with regard to debt (e.g., debt counselors), right from the outset of the supervision. Research has shown that difficulties in collaboration between organizations impede the continuity of care and negatively influences the reintegration process of clients (de Vogel et al, 2019). Therefore, better collaboration and adequate and timely information sharing (respecting privacy legislation) between probation and other organizations, such as debt counseling, may help probation officers better supervise clients with debt problems and reduce crime relapses.…”