Suivi longitudinal des patients psychiatriques médico-légaux : focus sur les taux de récidive et les scores de risque

Abstract

Research concerning the follow-up of forensic patients after their release from a high-security facility into the community is scarce. However, results available indicate that revocation rates are rather high. Our research aimed to answer three aspects based on an analysis of court records of 168 patients discharged from a Belgian secure forensic psychiatric hospital between 2014 and 2018: (1) the revocation and recidivism rates during a 3-year follow-up period; (2) the prevalence and motives for revocations of probationary released; (3) the comparison of scores of the Violence Risk Appraisal Guide-Revised (VRAG-R) between three release measures. To our knowledge, our study is the first to compare violent recidivism risk scores between release types. The mean VRAG-R scores were higher among revoked than conditioned released patients. The latter presented higher mean score than definitively released patients. The overall results are congruent with the “good practice” of the risk principle, hence supporting the importance of basing release decisions on risk assessment principles such as the VRAG-R in a longitudinal perspective.