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[Forensic (F)ACT: a study exploring indication, risk assessment and recidivism].

I Kusters, J E van Horn, T E A Cnossen

Tijdschrift Voor Psychiatrie

|October 18, 2018

Summary

Clinical indication criteria for forensic assertive community treatment (For(F)ACT) in the Netherlands showed a weak correlation with risk factors for criminal behavior. A combination of criteria best predicted recidivism in forensic clients.

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Area of Science:

Forensic Psychiatry
Mental Health Care
Criminology

Background:

Increasing burden on Dutch outpatient forensic care due to clinical bed cutbacks.
Dutch forensic (flexible) assertive community treatment (For(F)ACT) teams provide intensive outpatient care for complex forensic mental health issues since 2007.
Growing demand for clear indication criteria for effective For(F)ACT services and reduced criminal behavior.

Purpose of the Study:

To investigate the correlation between clinical indication criteria and criminal risk factors in For(F)ACT clients.
To identify which criteria best predict recidivism.
To inform the development of unambiguous indication criteria for adequate forensic care.

Main Methods:

Study of 76 For(F)ACT clients in The Netherlands.
Analysis of the correlation between clinical indication criteria and risk factors for criminal behavior.
Receiver operating characteristic (ROC) analysis to determine predictive accuracy.

Main Results:

A weak correlation was observed between the current clinical indication criteria and general risk factors for criminal behavior.
A combination of specific clinical indication criteria demonstrated the best predictive power for recidivism.
Identified key treatment factors: disrupting patterns, enhancing safety, and providing social/financial support.

Conclusions:

Influential risk factors for For(F)ACT clients differ from those in other delinquent populations.
Clinical indication criteria should not be replaced by START risk factors.
Effective treatment for For(F)ACT clients involves multifaceted support beyond traditional risk assessment.