Risk assessment and treatment in Dutch forensic psychiatry

The Dutch Code of Criminal Law has a special measure for defendants who are considered to have diminished responsibility for their offence on account of a serious mental disorder. This is known as the TBS order. The TBS is directed at changing the offender's recidivism risk by means of forensic psychiatric treatment. During the last decade, structured violence risk assessment has received increasing attention in research and practice within Dutch forensic psychiatry. Several risk assessment tools, such as the HCR-20 and HKT-30, have been validated for Dutch forensic psychiatric patients. Research into the effectiveness of forensic treatment under the TBS order is scarce and consists mainly of naturalistic pre-post designs. These studies show limited effectiveness of the treatment, but were carried out in just a few of the 13 forensic hospitals. Currently, a few studies using a control group consisting of care-as-usual, are underway. Notwithstanding these recent research efforts, Dutch forensic psychiatry remains under the close scrutiny of the media, politicians and public to show its effectiveness in reducing violent crime. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (from the journal abstract)