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        Can we harmonise forensic psychiatry across Europe?
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        Can we harmonise forensic psychiatry across Europe?
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        Can we harmonise forensic psychiatry across Europe?
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In their article Gordon & Lindqvist (Psychiatric Bulletin, November 2007, 31, 421–424) refer to harmonisation of forensic psychiatry in Europe. We agree with the authors that, although laudable in principle, such undertaking is difficult, if not impossible, to achieve. However, it is possible to share experiences and learn from each other. One example of cooperation in forensic services between European countries is the development of the Dangerous and Severe Personality Disorder Programme (DSPD) in England, which was initially inspired by the Dutch Terbeschikkingstelling (TBS) system.

Under TBS, the Dutch Criminal Code allows the detention of high-risk offenders with mental disorder. TBS has two components – a prison sentence followed by treatment in designated forensic units (van Marle, 2002). The duration of the sentence depends on the nature of the crime committed and the level of culpability.

Although it seemed prudent to adapt the TBS model, which had been tested over time, the final DSPD proposal came out fundamentally different. TBS order is issued and terminated by the courts, whereas in DSPD, offenders are detained under the provisions of the Mental Health Act 1983. This is despite earlier calls to develop a new strategy for high-risk offenders led by the judiciary, with psychiatrists’ support (Coid & Maden, 2003). The result has been criticism that psychiatry is being used for exercising social control. In our opinion such a composite arrangement meets neither the Dutch rehabilitative approach nor the public protection agenda.

Coid, J. & Maden, T. (2003) Should psychiatrists protect the public? A new risk reduction strategy, supporting criminal justice, could be effective. BMJ, 326, 406407.
van Marle, H. J. C. (2002) The Dutch Entrustment Act (TSB): Its principles and innovations. International Journal of Forensic Mental Health, 1, 892.