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. 2021 Jan;56(1):109-117.
doi: 10.1007/s00127-020-01909-6. Epub 2020 Jul 10.

Forensic mental health in Europe: some key figures

Jack Tomlin  1 , Ilaria Lega  2 , Peter Braun  3 , Harry G Kennedy  4   5 , Vicente Tort Herrando  6 , Ricardo Barroso  7 , Luca Castelletti  8 , Fiorino Mirabella  9 , Franco Scarpa  10 , Birgit Völlm  11 ; experts of COST Action IS1302
Collaborators, Affiliations

Forensic mental health in Europe: some key figures

Jack Tomlin et al. Soc Psychiatry Psychiatr Epidemiol. 2021 Jan.

Abstract

Purpose: While the number of forensic beds and the duration of psychiatric forensic psychiatric treatment have increased in several European Union (EU) states, this is not observed in others. Patient demographics, average lengths of stay and legal frameworks also differ substantially. The lack of basic epidemiological information on forensic patients and of shared indicators on forensic care within Europe is an obstacle to comparative research. The reasons for such variation are not well understood.

Methods: Experts from seventeen EU states submitted data on forensic bed prevalence rates, gender distributions and average length of stay in forensic in-patient facilities. Average length of stay and bed prevalence rates were examined for associations with country-level variables including Gross Domestic Product (GDP), expenditure on healthcare, prison population, general psychiatric bed prevalence rates and democracy index scores.

Results: The data demonstrated substantial differences between states. Average length of stay was approximately ten times greater in the Netherlands than Slovenia. In England and Wales, 18% of patients were female compared to 5% in Slovenia. There was a 17-fold difference in forensic bed rates per 100,000 between the Netherlands and Spain. Exploratory analyses suggested average length of stay was associated with GDP, expenditure on healthcare and democracy index scores.

Conclusion: The data presented in this study represent the most recent overview of key epidemiological data in forensic services across seventeen EU states. However, systematically collected epidemiological data of good quality remain elusive in forensic psychiatry. States need to develop common definitions and recording practices and contribute to a publicly available database of such epidemiological indicators.

Keywords: Beds; Deinstitutionalization; Europe; Forensic mental health; Prevalence.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Forensic in-patient prevalence rate per 100,000 year 2013
Fig. 2
Fig. 2
Gender of persons in forensic care as inpatients, year 2013
Fig. 3
Fig. 3
Mean length of stay for forensic in-patients (in years)
See this image and copyright information in PMC

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References

    1. Salize HJ, Dreßing H (2005) Placement and treatment of mentally ill offenders – legislation and practice in EU Member States. Pabst Scientific Publishers, Lengerich Berlin Bremen Miami Riga Viernheim Wien Zagreb
    1. Sampson S, Edworthy R, Völlm B, Bulten E. Long-term forensic mental health services: an exploratory comparison of 18 European countries. Int J Forensic Ment Health. 2016 doi: 10.1080/14999013.2016.1221484. - DOI
    1. Chow WS, Priebe S. How has the extent of institutional mental healthcare changed in Western Europe? Analysis of data since 1990. BMJ Open. 2016;6:10188. doi: 10.1136/bmjopen-2015. - DOI - PMC - PubMed
    1. Gunn J, Mevis P (2018) Adversarial versus inquisitorial systems of trial and investigation in criminal procedure. In: Forensic psychiatry psychol. Eur. Springer, Cham, pp 3–17. 10.1007/978-3-319-74664-7_1
    1. Zinkler M, Priebe S. Detention of the mentally ill in Europe—a review. Acta Psychiatr Scand. 2002;106:3–8. doi: 10.1034/j.1600-0447.2002.02268.x. - DOI - PubMed