The navigation of good care for forensic psychiatric inpatients who face mandatory repatriation from the Netherlands: An ethnographic study

Abstract

This ethnographic study examines the challenges associated with forensic psychiatric care for patients with a migration background in Dutch Centre for Transcultural Psychiatry Veldzicht. As a result of their criminal offence, these patients, translated here as ‘TBS foreigners’, have been declared ‘unwanted’ by the Dutch immigration services and face repatriation to their country of origin. Through contextual policy-analysis, participant observation and fifteen semi-structured interviews conducted between February and May 2023, we found that professional conduct on TBS foreigners' wards is increasingly curtailed by the Dutch legal infrastructure and the clinic's socio-material environment. This paper highlights how socio-therapists understand and navigate good care on wards where contrasting transcultural, forensic and psychiatric care objectives converge. Notably, ‘good’ transcultural care has become fraught in light of mandatory repatriation, in which we divide socio-therapists' approaches into static, dynamic and experiential. We argue those with a static approach to cultural differences with patients are most stuck in their daily work, because their goal of adopting a non-assumptive attitude has become intertwined with preparing a patients' return to society, which in these cases requires practical knowledge about a foreign country. Still, socio-therapists can find professional purpose and empowerment by focusing on each patient's humanity and creating meaningful activities within the available limits. This paper uniquely unravels lived experiences and resourcefulness of professionals providing transcultural care in forensic psychiatry, an intersection which is a growing area of concern globally. Hereby, we ensure such complex care settings can be discussed and potentially strengthened through institutional and/or national policy.