The Action facilitates a comprehensive, interdisciplinary programme of activities that bring together the extensive, but currently highly fragmented and scattered knowledge and resources on long-term forensic psychiatric care in Europe. To insure a large diffusion of the main outcome of the Action, ´best practice´ in long-term forensic psychiatric care in Europe, it is organised around 3 core areas:
- Characteristics of long-term forensic psychiatric patients
- Towards best practice in long-term forensic psychiatric care
- Meeting needs and optimizing quality of life in long-term forensic psychiatric care
The three core areas are each approached by an open Working Group, comprising of researchers and practitioners from different disciplines and at different stages of their careers who will resolve the theoretical, methodological and empirical implications within these core areas.
Working Group 1:
Determination of patient characteristics
The main aim of this Working Group will be to identify the determinant characteristics of patients in long-term forensic care. In order to understand the poor treatment progress of these patients it is necessary to get an overview of the characteristics of the patients that get stuck in the forensic service system. The WG will determine these characteristics and investigate what is needed for these patients in order to achieve more treatment progress and/or let them reside in services with lower levels of care and/or security. More specifically, this core area will concentrate on:
a) Getting a European, statistical overview of the prevalence of these patients residing in the different types of the secure services with corresponding levels of care and security.
b) Identifying the most determinant patient characteristics of this population, for example psychopathology, treatment history, risk assessment and index offence (note that, this list of characteristics is not exhaustive and the exact determinant characteristics of long-term forensic psychiatric patients need to be clarified empirically).
c) Classifying different patient subgroups within long-term forensic psychiatric care in order to develop more adequate treatment pathways for these subgroups.
Working Group 2:
Best practice in long-term forensic psychiatric care
The overall aim of this Working Group is to obtain a better understanding of the complex external factors that influence the poor progress of patients residing for an above average time in forensic services. Rather than focusing upon the patient itself, this core area will explore what external factors might contribute to better practice.
More specifically, this core area will be focusing upon the determination of policy regulations like juridical contexts, admission responsibilities and economic implications. Regulations at national as well as inter- and transnational level will be described by the Action, which will result in a European overview of the disadvantages and advantages of the different European systems with regard to patient progression.
Another key issue of this core area will be the influence of clinical practice by examining factors such as the treatment programs that have been followed and indexing which staff interventions have been provided. Also, the ‘what works’ experiences of practitioners within long-term forensic psychiatric care (e.g. psychiatrists, psychologists, nurses) will be systematically explored.
Working Group 3:
Meeting patient needs and optimizing quality of life
The primary aim of this core area is to gain knowledge about the specific needs brought about by (severe) psychiatric symptoms and long-term residence in a highly restrictive setting and, on how meeting these specific needs might optimize the quality of life of patients in long-term forensic psychiatric care.
More concretely, this core area involves the determination of patients’ needs for psychosocial, mental health and physiological care. What are the experiences of patients residing in long-term forensic care, and what do they need in order to reside for a (life-)long period of time in a highly restrictive environment? These are the type of questions being addressed in this core area.
Another closely related key issue is the experienced quality of life of patients. This entails a subjective evaluation of the more objective needs. It is defined as an overall sense of well-being and satisfaction by people under their current living conditions. The Action aims to catch the experiences of long-term forensic psychiatric patients and their perception on these experiences by determining needs and defining quality of life.