About detention under hospital orders (TBS)

At the Van der Hoeven Kliniek, we treat people on whom a court has imposed detention under a hospital order. This is not a punishment but an order that a court is able to impose. A court will only impose a hospital order with compulsory psychiatric treatment on people who have been declared partially or fully unaccountable for their actions. Research has often demonstrated that these people have psychiatric problems and have committed serious offences (partly as a result of their psychiatric problems). These offences must be such that they are worthy of the imposition of detention under a hospital order and a custodial sentence of at least four years. There must also be a chance of recidivism. After completing a custodial sentence, the suspect will be admitted to a forensic psychiatric centre like the Van der Hoeven Kliniek. The individual in question will have no say in this matter.

The fact that a patient receives treatment in a secure, closed institution contributes to safety in society. The object is to reduce the likelihood that a patient will re-offend and also to take steps to ensure his safe re-entry into society.

Extension

A hospital order will apply for two years initially. Once this period has expired, the court will be able to extend detention under a hospital order by one or two years on each occasion. The forensic hospital will advise the court on whether or not to proceed to decide to extend an order in an extension court session. This advice will be based on the course and progress of treatment and on an assessment of the likelihood of recidivism through the use of a risk assessment. The average treatment period applicable at the Van der Hoeven Kliniek for a patient who has been detained under a hospital order is 7.3 years (2012). Because it is always possible to extend a hospital order, it is possible to avoid detention under a hospital order lasting too long. At the hospital, patients are expected to observe the rules in place there. However, if someone fails to cooperate in his treatment, the likelihood of recidivism will not decrease. In this situation detention under a hospital order will not be terminated.

Unique in the world

Detention under a hospital order is unique to the Netherlands. In other countries, people are sent to prison or to a psychiatric institution. The combination of both institutions in a forensic hospital is something that exists only in the Netherlands. Many of the people who end up in a forensic institution have a psychological disorder and often psycho-social problems too. Patients who are treated at the Van der Hoeven Kliniek often have one or more of the psychiatric disorders indicated below:

  • Personality disorders
  • Psychotic disorders
  • Autism spectrum disorders
  • The abuse of or a dependence on substances

These disorders are often accompanied by sexually unacceptable and deviant behaviour and/or (verbal or physical) aggression towards others and our patients display symptoms of different psychological disorders. This makes the achievement of a clear diagnosis a complex matter. If a patient has a combination of disorders, or one disorder and an addiction problem, we refer to this as comorbidity. Treatment provides patients with an insight into their problems and they learn how to cope with them. Treatment is used to work towards the safe re-entry of patients into society. Recidivism figures show that detention under a hospital order works. People who have only completed a custodial sentence re-offend almost 2.5 times more often than people who receive treatment under a hospital order after completing their custodial sentences.

Van der Hoeven Kliniek is onderdeel van De Forensische Zorgspecialisten