Transforensic psychiatry: Addressing inpatient aggression in the 'gray zone' between general and forensic psychiatric care

Joost à Campo, Alfons van Impelen*, Nicole Hamakers, Henk Nijman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

A minority of psychiatric patients are unfit for general psychiatric care due to offensive behavior that renders them at risk of coming into contact with the criminal justice system. In the absence of criminal proceedings, these patients find themselves in the "gray zone" between general and forensic psychiatric care. To accommodate these patients, we established a "transforensic" ward. Instead of applying forensic treatment elements reactively (as part of a criminal sentence, after an offense has been committed), we applied it preventively (so as to avert offending behavior and resultant criminal sentences). Psychometric psychopathology and violence risk assessment scores were substantially lower at discharge than at admission (Cohen's ds = -0.3 to -0.6). These results offer ground for cautious optimism about the efficacy of transforensic care in serving as a safety net for psychiatric patients who are found to be unfit for general psychiatric care on account of their aggressive behavior.

Original languageEnglish
Pages (from-to)141-154
JournalBehavioral Sciences & the Law
Volume41
Issue number4
Early online date8 Nov 2022
DOIs
Publication statusPublished - Jul 2023

Keywords

  • aggressive behavior
  • forensic treatment
  • mental health care
  • transforensic psychiatry
  • violence risk assessment

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