Written by Peter Braun,
Manager Long-Term Forensic Psychiatric Care, Pompefoundation, the Netherlands.
On the 27th of January ´Festival Forensische Zorg´, a large conference in the Netherlands was organized by the Dutch Ministry of Safety and Justice. The conference attracted a wide audience from Forensic Psychiatric organizations, clinics, detention centres, forensic outdoor-facilities and service-users organizations, volunteers, probation-officers, sheltered living facilities for ex-forensic patients and many more.
Being there was a bit like being at a festive market, walking amongst crowds of likeminded people who were naturally drawn to the information presented by the many stallholders. There were more than 120 talks, workshops, TED-talks, presentations concerning the newest developments and ideas in Forensic Psychiatry in the Netherlands. There were presentations concerning risk-management systems, structured risk-assessment instruments and research results or plans. Three innovations attracting a lot of attention were the use of E-mental health programs for forensic psychiatry, treatment evaluation methods involving the use of web-based treatment planning systems and e-learning modules for training staff.
For many workers in the Dutch forensic system this annual conference is the best way to meet colleagues from other organizations. For everybody who attends, it is a great way to keep abreast of the newest developments and trends in forensic psychiatry. As the conference venue is paid for by the Ministry, and presenters attend for free, the ticket price for an interested person is just € 195. This makes the conference very accessible, and many people attend. Every year there are about 800 persons present, mostly workers in forensic psychiatry. Because the organisation is interested in good practice-based ideas from the field, many best practices are presented and discussed with clinicians, researchers and service providers. Policy is not the main issue in this conference.
The conference was opened by the Chair of the Board of Directors of one of the largest Mental Health organisations who stressed the need to use the knowledge and experience of users and ex-users in forensic psychiatry. And it was good to see, in the reports of those who attended the workshop, that the participation of ex-service users was indeed valuable.
It was very interesting to hear from ex-service users and their family-members about their personal experiences with forensic treatments, the professionals in the industry they interacted with and their impressions of the forensic system as a whole. This prompted a lively discussion between forensic professionals, members of the prosecution and lawyers, which was a very valuable exchange of ideas on the possibilities of development of improved policy for the long-term forensic psychiatric care.
The positive feedback about the conference calls for preparing patients for this kind of involvement. As this is a relatively new way of participation and improvement, appropriate preparation methods – training and supervision programs – would need to be available. This kind of training for ex-patients does exist in the Netherlands but relatively few programs exist for forensic patients, and programs for long-term forensic patients do not exist at all. It would be very helpful if such training could be set up and executed for interested (ex)service-users throughout Europe. In my opinion, this represents a great opportunity to support the recommendations outlined in the COST Action 1302 “Towards an European Research Framework on Forensic Psychiatric Care”.
Erik Bulten (Scientific Coordinator of the COST Action) presented the goals and working groups of the COST-Action IS1302. This presentation was followed by a Q&A session that gauged participants’ interest in various research questions in this field and ideas how to proceed with these questions.
A significant part of the discussion groups, workshops and debates addressed topics related to long-term forensic psychiatric care. It was encouraging to hear how the concept of “Longstay” is evolving in the Dutch situation. After years of discussion, stakeholders have agreed that the set of regulations concerning long-term forensic psychiatric patients will bear the title “Long-term Forensic Psychiatric Care” instead of the former title “Longstay”. This change indicates the acceptance that what is done within this work, is not without differing perspectives. “Longstay” does not simply mean “staying for a (very) long time”. It also means “care that’s needed for longer than expected”. It seems to be a small change, but it represents acknowledgement from the Ministry of Safety and Justice and creates space for more ways of thinking about the possibilities and difficulties experienced by this group of patients.
The budget cuts due to occur this year will force us even more to be creative and innovative – to do more with less; to do different things when outcomes are not sufficient. Repeating what has been done before and expecting a different outcome is neither logical nor efficient. New ways can, and must, be explored. The Festival was a milestone toward this aim. I am looking forward to next years’ conference taking place in January 2016.