Triage urgency criteria for patients on the high security waiting list

This study evaluates the application of the DUNDRUM-2 Triage Urgency scale for prioritizing admissions to high security forensic psychiatric centers in Flanders, given forensic bed shortages and extended waiting periods. A retrospective cohort of 120 admitted patients was examined to compare DUNDRUM-2 scores of prioritized admissions with regular admissions and to assess the instrument's reliability and validity. Results indicated that prioritized patients scored significantly higher, with nearly nine out of ten displaying urgent or very urgent needs. One third of the regular patients also had urgent needs, highlighting resource allocation challenges. Psychometric analyses revealed weak internal consistency and there were scoring difficulties, suggesting limitations in applying DUNDRUM-2 within Belgium's clinical and judicial framework. Despite these limitations, DUNDRUM-2 showcased potential in enhancing transparency and accountability in decision-making processes. Recommendations include adapting the scale to better align with the Belgian context and undertaking further validation to optimize forensic psychiatric care.