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Improving continuity of forensic mental health care

Vivienne de Vogel (Department of Research, De Forensische Zorgspecialisten, Utrecht, The Netherlands) (University of Applied Sciences Utrecht, Utrecht, The Netherlands)
Petra Schaftenaar (Metis Zorg, Utrecht, The Netherlands)
Maartje Clercx (FPC de Rooyse Wissel, Oostrum, The Netherlands)

The Journal of Forensic Practice

ISSN: 2050-8794

Article publication date: 7 August 2019

Issue publication date: 7 August 2019




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.


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.


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.


Policy programs hardly reach professionals. Professionals see improvements in collaboration as top priority. Patients emphasize the human approach and transparent communication.



No potential conflict of interest is reported by the authors. The authors would like to thank all professionals and patients who participated in this study. This study was funded by Grant KFZ 2018-79 from the Dutch program Kwaliteit Forensische Zorg (Quality of Forensic Care). The principles outlined in the Declaration of Helsinki were followed in this study.


de Vogel, V., Schaftenaar, P. and Clercx, M. (2019), "Improving continuity of forensic mental health care", The Journal of Forensic Practice, Vol. 21 No. 3, pp. 180-189.



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