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Crushed by the Belgian system : lived experiences of forensic care trajectories by persons labelled as not criminally responsible

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Abstract
Background: Care trajectories of Persons labelled Not Criminally Responsible (PNCR) are often characterized by multiple transitions from one (forensic) mental health service to another and by long periods of admission. So far, little research has been conducted on forensic care trajectories, in particular on how PNCR perceive the trajectories they are subjected to. Method: Data were obtained via semi-structured interviews (N = 23) with PNCR in various (forensic) mental health services in Belgium. A maximum variation sampling strategy was applied to recruit a heterogeneous group of PNCR and inductive thematic analysis adopted to analyse the data. Results: PNCR's experiences about care trajectories in Belgium are marked by an absent voice and passive position in the decision-making process in addition to a lack of support during transitions. Barriers for admission in (forensic) mental health services and the indeterminate duration of care trajectories contribute to overall negative lived experiences. Conclusion: Although some findings are interchangeable with general mental health care, PNCR's care trajectories differ by their undetermined nature, barriers for accessing care and power dynamics in compulsory forensic care. As concepts from prison sociology, such as tightness, power holders and pain of indeterminacy, seem to be equally relevant for the situation of PNCR, the balance between a criminal justice and mental health approach in forensic mental health care is questioned.
Keywords
Pathology and Forensic Medicine, Law, Psychiatry and Mental health, Forensic mental health, Forensic psychiatry, Persons labelled not criminally responsible, Forensic care trajectories, Service user perspective, Lived experiences, SERVICE USERS PERCEPTIONS, MENTALLY-ILL OFFENDERS, SHARED DECISION-MAKING, PROCEDURAL JUSTICE, ASSOCIATION

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MLA
De Pau, Marjolein, et al. “Crushed by the Belgian System : Lived Experiences of Forensic Care Trajectories by Persons Labelled as Not Criminally Responsible.” INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY, vol. 68, 2020, doi:10.1016/j.ijlp.2019.101539.
APA
De Pau, M., Mertens, A., Bourmorck, D., Vanderplasschen, W., Nicaise, P., & Vander Laenen, F. (2020). Crushed by the Belgian system : lived experiences of forensic care trajectories by persons labelled as not criminally responsible. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY, 68. https://doi.org/10.1016/j.ijlp.2019.101539
Chicago author-date
De Pau, Marjolein, Anouk Mertens, Delphine Bourmorck, Wouter Vanderplasschen, Pablo Nicaise, and Freya Vander Laenen. 2020. “Crushed by the Belgian System : Lived Experiences of Forensic Care Trajectories by Persons Labelled as Not Criminally Responsible.” INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 68. https://doi.org/10.1016/j.ijlp.2019.101539.
Chicago author-date (all authors)
De Pau, Marjolein, Anouk Mertens, Delphine Bourmorck, Wouter Vanderplasschen, Pablo Nicaise, and Freya Vander Laenen. 2020. “Crushed by the Belgian System : Lived Experiences of Forensic Care Trajectories by Persons Labelled as Not Criminally Responsible.” INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 68. doi:10.1016/j.ijlp.2019.101539.
Vancouver
1.
De Pau M, Mertens A, Bourmorck D, Vanderplasschen W, Nicaise P, Vander Laenen F. Crushed by the Belgian system : lived experiences of forensic care trajectories by persons labelled as not criminally responsible. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY. 2020;68.
IEEE
[1]
M. De Pau, A. Mertens, D. Bourmorck, W. Vanderplasschen, P. Nicaise, and F. Vander Laenen, “Crushed by the Belgian system : lived experiences of forensic care trajectories by persons labelled as not criminally responsible,” INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY, vol. 68, 2020.
@article{8643371,
  abstract     = {Background: Care trajectories of Persons labelled Not Criminally Responsible (PNCR) are often characterized by multiple transitions from one (forensic) mental health service to another and by long periods of admission. So far, little research has been conducted on forensic care trajectories, in particular on how PNCR perceive the trajectories they are subjected to.

Method: Data were obtained via semi-structured interviews (N = 23) with PNCR in various (forensic) mental health services in Belgium. A maximum variation sampling strategy was applied to recruit a heterogeneous group of PNCR and inductive thematic analysis adopted to analyse the data.

Results: PNCR's experiences about care trajectories in Belgium are marked by an absent voice and passive position in the decision-making process in addition to a lack of support during transitions. Barriers for admission in (forensic) mental health services and the indeterminate duration of care trajectories contribute to overall negative lived experiences.

Conclusion: Although some findings are interchangeable with general mental health care, PNCR's care trajectories differ by their undetermined nature, barriers for accessing care and power dynamics in compulsory forensic care. As concepts from prison sociology, such as tightness, power holders and pain of indeterminacy, seem to be equally relevant for the situation of PNCR, the balance between a criminal justice and mental health approach in forensic mental health care is questioned.},
  articleno    = {101539},
  author       = {De Pau, Marjolein and Mertens, Anouk and Bourmorck, Delphine and Vanderplasschen, Wouter and Nicaise, Pablo and Vander Laenen, Freya},
  issn         = {0160-2527},
  journal      = {INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY},
  keywords     = {Pathology and Forensic Medicine,Law,Psychiatry and Mental health,Forensic mental health,Forensic psychiatry,Persons labelled not criminally responsible,Forensic care trajectories,Service user perspective,Lived experiences,SERVICE USERS PERCEPTIONS,MENTALLY-ILL OFFENDERS,SHARED DECISION-MAKING,PROCEDURAL JUSTICE,ASSOCIATION},
  language     = {eng},
  pages        = {8},
  title        = {Crushed by the Belgian system : lived experiences of forensic care trajectories by persons labelled as not criminally responsible},
  url          = {http://dx.doi.org/10.1016/j.ijlp.2019.101539},
  volume       = {68},
  year         = {2020},
}

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