Patient Groups with Different Risk Profiles for Irregular Drop- Out from Forensic Psychiatry ( 64 StGB)

Objective: About 50-70% of the patients with substance abuse disorders who are mandated to forensic treatment according to the section 64 of the German penal code are discharged from treatment irregularly. Previous research identified a number of potential risk factors for irregular treatment dropout. Systematic assessment of risks factors and their consideration for treatment planning may help to improve treatment retention. Therefore, the aim of this study was to identify groups of patients with a comparable risk profile for treatment dropout. Methods: From 2007-2012, patients entering forensic treatment completed the MATE-Crimi and a sociodemographic questionnaire. Results: From 431 patients entering forensic treatment, 357 patients agreed to participate. Of the 357 included patients 35.9% had completed the forensic treatment irregular. Using cox regression, young age, low treatment motivation and a primary criminal behaviour with the substance use as a consequence of criminal behaviour were identified as risk factors for early drop-out. A subsequent analysis of latent classes using these variables resulted in three classes. Conclusions: Our study revealed a small number of risk factors being relevant for treatment drop-out. Furthermore, we identified three groups of patients with different risk profiles. Next steps include the development of treatment pathways for these patient groups

People out of place: allochthony and autochthony in the Netherlands' identity discourse — metaphors and categories in action

Contains fulltext : 112997.pdf (publisher's version ) (Closed access)As with much of Europe, the Netherlands has no explicit ‘race’ discourse; however, the state, through its public policy and administrative practices, does categorise its population along ‘ethnic’ lines, using birthplace — one's own or one's (grand-) parent's — as the surrogate determining factor. The contemporary operative taxonomy has until recently been binary: autochtoon (of Dutch heritage) and allochtoon (of foreign birth). Used earlier at the provincial level in respect of internal migration, the taxonomy was expanded in 1999 to demarcate between ‘Western’ allochtoon and ‘non-Western’ allochtoon, with the latter being further subdivided into first and second generation. Informed by a ‘generative metaphor’ approach (Schon 1979) that links cognition to action, this article subjects the allochtoon/autochtoon binary to metaphor analysis and the Western/non-Western taxonomy to category analysis. The work done by ‘birthplace’ in the term pair suggests that they are, in their everyday usage, surrogates for a race discourse, carrying the same (ancient) assumptions about individual identity and the earth-air-sun-water of the spot on which one was born that underlies definitions-in-use of ‘race’. Their meaning in contemporary policy discourse derives from the interaction of metaphoric and category structures, with implications for policy implementation.35 p