Forensic Outpatient Variables That May Help to Prevent Further Detention

Abstract

Background: Forensic outpatient treatment in Germany helps forensic patients back into society while managing the risk that these individuals present to public safety. Measures used to achieve this objective include ongoing psychiatric treatment and monitoring, case management, and controlling risk factors that may cause criminal behavior. In addition to the effects of treatment and control, good living conditions have been hypothesized to help prevent criminal recidivism and a number of studies have examined variables related to poor outcomes including recidivism among former prison inmates and sexual offenders. Yet, little is known about the predictive validity of certain candidate variables on the outcomes of German forensic outpatients. Methods: In order to investigate variables that are likely to reduce the risk of unfavorable outcomes such as subsequent confinement or back-referral to inpatient treatment, we analyzed data from a forensic outpatient data project run by the federal state of Baden-Württemberg (Forensic outpatient documentation system). Based on data provided by six forensic treatment units throughout the federal state of Baden-Württemberg since 2015, we compared 61 forensic outpatients that had either regularly ended treatment (group one, n = 25), or were referred back to a forensic hospital or prison (group two, n = 36). Information on the patients' working, living, and financial situation as well as information on their social network and relationship status, was used. The predictive validity of these factors on treatment outcome was tested with a logistic regression model. Results: There were a number of a priori differences between the groups, but pro-social leisure activities in an outpatient environment and migration status were the only significant predictors of positive vs. negative outcome. Discussion: Implications of these findings are discussed.

The effectiveness of an additive informal social network intervention for forensic psychiatric outpatients: results of a randomized controlled trial

“…There is an urgent and ongoing need to develop and improve effectiveness of evidence-based interventions for forensic psychiatric patients ( 10–13 ). A supportive social network is considered an important protective factor that may improve mental health outcomes and reduce criminal recidivism in forensic psychiatric care ( 14–16 ). Yet, the effectiveness of interventions aimed at promoting supportive social networks among forensic psychiatric patients has remained unclear.…”

“…A supportive social network is considered an important protective factor against mental health problems and criminal recidivism ( 14–18 ). Multiple cross-sectional studies found that social support is positively related to mental health (recovery) and mental wellbeing in general and psychiatric populations ( 19–22 ).…”

Risk assessment and provisional discharge: Predictive utility of the HCR-20.

“…The utility of unit data in provisional discharge decisions and outcome is made clear by the present findings. Specifically, individuals who successfully traversed the hospital level systems are more likely to both be discharged and successful on such discharge (Klinger et al, 2020) and that includes the ability to work with a treatment team and establish mutual goals relevant to discharge planning (McDonnaugh et al, 2020). Transitions to lower security levels are associated with stability and greater focus on preparedness for community reintegration.…”

Patients’ and volunteer coaches’ experiences with an informal social network intervention in forensic psychiatric care: a qualitative analysis

“…Simultaneously, a supportive social network consisting of individuals with criminal attitudes and behaviors is related to an increased risk of criminal recidivism [ 11 , 12 ]. Furthermore, previous research has extensively established positive effects of social support on other relevant treatment outcomes, such as mental health recovery, wellbeing, and quality of life in (forensic) psychiatric populations [ 8 , 13 – 15 ]. Therefore, interventions targeting social network enhancement in the community are potentially important in improving treatment outcomes of forensic psychiatric outpatients with limited supportive social networks.…”