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Tijdschrift voor Psychiatrie 60 (2018) 10, 672 - 681


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

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

background Cutbacks in clinical beds in regular and forensic psychiatry increase the burden on outpatient forensic care in The Netherlands.
aim Since 2007, Dutch forensic (flexible) assertive community treatment (For(f)act) teams offer outpatient, intensive treatment to forensic clients with complex mental health issues. As the need for this form of intensive treatment increases, so does the need for unambiguous indication criteria to facilitate adequate care and accompanied reduction in criminal behavior.
method The present study investigated the correlation between the clinical indication criteria and risk factors for criminal behavior in 76 For(f)act-clients, reviewing which criteria best predicted recidivism.
results A weak correlation was found between the indication criteria and risk factors. Further receiver operating characteristic (roc) analysis showed that a combination of clinical indication criteria best predicted recidivism.
conclusion The influential risk factors for For(f)act-clients are different compared to those for other groups of delinquents. Important treatment factors are breaking patterns, increasing safety and offering social and financial support. The clinical indication criteria should not be replaced by the start risk factors.

keywords indication criteria, reliability, predictive validity, recidivism.