TBS-behandeling geprofileerd (projectnummer 1897)

After several serious incidents with patients with a criminal justice order of enforced careby the state (TBS1) during unsupervised leave, the Lower House decided in 2006 to start aparliamentary inquiry into the functioning of the TBS system (the Visser commission). Thecommission reached the conclusion that the TBS system in general meets the tasks set to it,yet that it is necessary to adapt its execution to modern standards. One of the commission’srecommendations was to carry out more scientific research on the effectiveness oftreatment in forensic psychiatry. To this end, the Scientific Research and DocumentationCentre (WODC) drew up a TBS research programme, in cooperation with the TBS fieldand relevant actors. For the purpose of this TBS research programme a study was neededthat would take stock of and describe the current execution of the TBS sentence.This report is the reflection of this stock-taking and descriptive study and of aquantitative analysis of a representative sample of prisoners sentenced to TBS. The studyconsists of two parts. The first part presented a description of the characteristics of theresearch population, the execution of the TBS sentence, the design of this execution, theformal legal framework, the bottlenecks and the question in which ways the execution –and more specifically the treatment - is in keeping with the scientific research. In thesecond part, the profiles of the group of studied prisoners sentenced to TBS were drawnup.In this study, we have used four research methods to answer the research questions: asynthesis of the literature, file research, interviews and focus groups. The aim of theliterature synthesis was to answer the research questions from a theoretical point of viewand to provide insight into the evidence-based treatment methods within the forensicdomain. The objective of the file research was, among other things, to gain anunderstanding of different aspects regarding patients and their treatment. The semistructuredinterviews were conducted to gain insight into the execution of the TBSsentence and in questions that could not be answered by means of the file research. Finally,we established three focus groups to provide an opportunity to key figures (treatmentdirectors, therapists and researchers) to reflect on the most important research results. Thefocus groups also gave input regarding aspects of the research that were insufficientlyilluminated by means of the file research.The sample size of the file research had been fixed by the WODC at 180 cases. Inthe thirteen Forensic Psychiatric Centres (FPCs), the cases were randomly sampled fromthe population present at the hospital at that moment. The number of selected cases foreach hospital was determined with a weighting factor. Included in the sample were patientswho had entered the hospitals after 1 February 2000. Excluded from the sample weredetainees sentenced to TBS who were indicated for long-stay forensic care and detaineessentenced to TBS who were living in the Netherlands illegally. We checked therepresentativeness for six characteristics: sex, age, offence category, primary disorder,1 In Dutch: ‘terbeschikkingstelling’, abbreviated from here on to ‘TBS’; we will use the untranslated term because of theuniqueness of the Dutch TBS-system) nationality and IQ. Data regarding five of the six characteristics could be provided by theFPCs, except for those regarding IQ; for this reason, the representativeness of the IQ waschecked on the basis of the scored file data.