Leave

We want to make patients’ re-entry into society as easy as possible. Because of this, we start the resocialisation process from their very first day at the clinic and introduce the possibility of leave as soon as possible too. Forty-three percent of people start leave within two years. Because we start leave at an early stage, the treatment period here is an average of 8.7 years (2015). Our rate of recidivism is low.

Permission

Leave for patients who have been detained under a hospital order is arranged via the leave assessment framework drafted by the Ministry of Security and Justice. The hospital will only be able to request leave for a patient when treatment staff (psychiatrists, therapists, group management, medical care, supervisors and teachers) and the Treatment Director believe that there is little risk, or a low risk, of delinquent behaviour and the patient has made sufficient progress with his treatment. Prior to each leave request, the patient in question will be required to write his own motivation, a risk assessment will be produced and the hospital council (a council made up of fellow patients) will give its advice. The independent Advisory Board on Review of Leave from Detention under a Hospital Order (Adviescollege Verloftoetsing tbs (AVT)) will assess leave requests and issue advice on them. The Custodial Institutions Agency (Dienst Justitiële Inrichtingen (DJI)) at the Ministry of Security and Justice will ultimately make a decision on behalf of the Minister. A leave authorisation will be granted for one year and may be extended on the basis of evaluation. The client will be expected to submit a new leave request for each change pertaining to leave and the leave request will then be assessed again. The Minister may decide to deviate from a positive advice issued by the Advisory Board on Review of Leave from Detention under a Hospital Order by not granting a leave authorisation. If the Advisory Board on Review of Leave from Detention under a Hospital Order issues a negative advice, the Custodial Institutions Agency will not be able to grant leave anyway.

Stages of leave

  • Supervised leave: In the first stage of leave, patients will be permitted to leave the hospital under supervision (supervised shopping, for example). The first five times that a patient is permitted to take supervised leave, he will be supervised by group management and by a member of staff who has been trained as a security guard. This is the so-called guarded stage. Next, the patient will be supervised by two group leaders, without a security guard. This is the so-called double supervised stage. Finally, just one group leader will supervise the patient during leave.
  • Unsupervised leave: If supervised leave has gone well, a patient will be permitted to take unsupervised leave. This leave will last from several hours to a maximum of six days. During this type of leave, a patient will have various options, including the possibility to gain work experience, do a course or visit family or friends.
  • Transmural leave: During transmural leave, a patient will be expected to show that his recidivism risk has been reduced to such an extent that it is safe to allow him to live outside the hospital in a property belonging to the hospital. Supervision and treatment will still be provided solely by the hospital. During trial leave, the Dutch Probation Service will supervise the patient, but the Van der Hoeven Kliniek will still be responsible for the patient.
  • Trial leave: During trial leave, a patient will have the opportunity to show that his recidivism risk has been reduced such that it is safe for him to have leave with less supervision from the hospital. During trial leave, the Dutch Probation Service will supervise the patient, but the Van der Hoeven Kliniek will still be responsible for him. At this stage, the patient will live independently, in a Regional Sheltered Housing Institution (Regionale Instelling voor Beschermd Wonen (RIBW)) or a standard mental healthcare institution. After this final leave stage, the court will be able to terminate detention under a hospital order (conditionally). In the event of the conditional termination of detention under a hospital order, forensic psychiatric supervision will almost always be put in place. In this situation, the hospital remains responsible for the patient, but treatment and supervision are taken over by an institution for outpatient forensic care (such as de Waag; also part of the De forensische Zorgspecialisten) and the Dutch Probation Service.

Van der Hoeven Kliniek is onderdeel van De Forensische Zorgspecialisten