What is it about?

Some psychiatric patients engage in aggressive behavior in such a way that they are likely to get into contact with the criminal justice system. To treat such behavior safely and effectively, it takes risk assessment and management. Risk assessment and management is a central part of forensic psychiatric mental health care, but not of regular psychiatric care. However, some aggressive patients have no access to forensic care, because no forensic disciplinary action is taken against them. We addressed this issue by establishing a “transforensic” ward, where we provide forensic care to psychiatric patients who would otherwise have no access to the forensic care that they are in need of.

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Why is it important?

Presently, there is no clear middle ground option between general and forensic mental health care. For psychiatric patients, forensic care tends to be accessible only after involvement in criminal justice procedures. Transforensic psychiatry aims to be the middle ground between general and forensic psychiatric care, where patients have access to forensic care regardless of their involvement in criminal justice procedures. By providing forensic mental health care before disciplinary actions are incurred, rather than after disciplinary actions are incurred, transforensic psychiatry may prevent criminally offensive behavior and reduce criminalization of mental illness.


Patients who repeatedly engage in aggressive behavior are often repelled from general psychiatric care on account of their behavior. Absent adequate treatment, these patient are high at risk of getting into contact with the criminal justice system. The tragedy of such situations is twofold, because in their aggressive acts, these patients victimize others and criminalize themselves. The goal of transforensic psychiatry is to prevent such twofold tragedies, and act as a safety net for patients whose behavior renders them a threat to the wellbeing and safety of others.

Alfons van Impelen

Read the Original

This page is a summary of: Transforensic psychiatry: Addressing inpatient aggression in the “gray zone” between general and forensic psychiatric care, Behavioral Sciences & the Law, November 2022, Wiley,
DOI: 10.1002/bsl.2602.
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