Written by Mareike Eckert, MSc,
Junior Researcher of the Pompe Foundation, the Netherlands
In May 2015 I completed a short term scientific mission (STSM) of one week to the Central Mental Hospital Dundrum in Dublin, Ireland in the context of the COST Action IS1302, working group 1: Determination of patient characteristics. The purpose of my stay was to explore, understand and compare factors affecting length of stay in a forensic population in the Netherlands and Ireland using the DUNDRUM toolkit and also a questionnaire about patient characteristics. Factors such as basic demographic information, length of stay, offending and psychiatric history, security and urgency needs, program completion and patient recovery were therefore assessed prior to the STSM including about 60 non-long term patients from different wards in the Pompe clinic in Nijmegen and about 60 long term patients, admitted to the long term forensic psychiatric care unit in Zeeland. Throughout my STSM I gained insight into how the DUNDRUM toolkit is used in practice in the Central Mental Hospital in Dublin. This was an important aspect of my STSM in order to fully understand how to use the toolkit in the research project.
In order to fully understand the purpose, use and development of the DUNDRUM-1 and -2 which are pre-admission tools triaging security and urgency needs I visited the Prison Inreach and Court Liaison Service (PICLS) at Cloverhill Remand Prison in Dublin. The PICLS was initiated in 2006 to screen systematically new receptions in order to decide who might have a mental disorder and will need special care either in the community or by admission to the Central Mental Hospital. Furthermore I visited many different meetings, decision boards and treatment groups at the Central Mental Hospital in order to gain more insight into the usage of the DUNDRUM-3 and -4, but also in order to get a closer look on the population regarding mental illness, treatment and length of stay. Another part of my STSM was discussing research possibilities on length of stay in the Netherlands and Ireland. By discussing possibilities with Prof. Harry Kennedy I got a better insight and understanding of the sort of data which will be useful to further explore the question on length of stay in longterm forensic psychiatric care.
My time in Ireland allowed me to further understand the usage and meaning of the DUNDRUM toolkit and gave me an in-depth understanding of the judicial system of Ireland regarding forensic mental health services. Those two aspects will help me to see important aspects that have to be considered when conducting a collaborative research on length of stay between Ireland and the Netherlands. For instance the aspect that patients with mainly personality disorder are not admitted to the Central Mental Hospital, but rather stay in the prison whereas this is different in the Netherlands is important to be aware of when comparing the population of Dutch long term patients and Irish long term patients.
My experience and new insights into factors affecting length of stay, but also the in-depth understanding of the DUNDRUM toolkit will help me to further develop the research on length of stay with the current data I gathered together with colleagues at the Pompe foundation prior to my STSM. My ambition for the following 6 months is to discuss and bring those ideas into action by using the current dataset collected at the LFPC and the Pompe Clinic to write an article together with Dr. Erik Bulten and Prof. Henk Nijman on factors concerning length of stay such as patient characteristics. Also I will use the DUNDRUM toolkit data to see whether it can be linked to length of stay and treatment outcome. Other colleagues might join this project.