Psychiatric clinics for criminals struggling with waiting lists

The Dutch system of psychiatric detention (tbs) is under increasing strain from long waiting lists, a growing pile of court orders and a lack of discharge places, new figures show.

The number of people waiting for a place in a tbs clinic has risen from 45 to 261 in the last five years, a near-sixfold increase, but last year only 118 were given a place in a clinic, down 24% from 2024.

Patients are being treated for longer, with the average treatment now lasting more than 10 years, and taking longer to be discharged, partly because of a lack of suitable sheltered housing.

The figures are contained in the annual report of TBS Nederland, the umbrella organisation for tbs institutions.

Tbs, short for terbeschikkingstelling, is a compulsory treatment order that is often added to criminal sentences by courts in the Netherlands. The court decides whether to order convicts to be detained in a clinic or undergo supervised treatment in the community.

Three clinics, the Kijvelanden, Oostvaarderskliniek and Veldzicht, have added extra beds to cope with the longer waiting list, but it has not been enough to meet demand.

The longer waiting list means criminals are having to spend longer in prison before they can access treatment, which is only available once they enter the last two years of their sentence.

Compensation claims

Last month the justice ministry’s research agency warned that the treatment was likely to be less effective if prisoners with mental health issues have to wait years before they could go into psychiatric care.

Patients who have to wait longer than four months to be admitted to a clinic are entitled to compensation. The total amount paid by the state rose from €25,250 to €356,554 between 2021 and 2024.

Longer treatments could also reflect a more cautious approach following a number of high-profile cases such as the murder of Anne Faber, who was killed in 2017 by a man who was undergoing treatment at a nearby tbs clinic.

Hyacinthe van Bussel, chair of TBS Nederland, said: “We have to ask ourselves if we have set the bar too high. We can never make guarantees, but maybe we have become too reluctant to take risks.”

Councils holding back

The risk of escape is extremely low: last year just 12 patients failed to return to their clinic at a pre-arranged time, none of whom committed offences while they were missing, out of more than 85,000 day releases.

Another problem TBS Nederland faces is the growing reluctance of local councils to provide accommodation for patients leaving TBS clinics, who often need supervision in sheltered accommodation.

“There is no longer so much tolerance in society,” Van Bussel said. “You see it with asylum seekers’ centres. There are councils that say: ‘We already have an asylum centre, a housing shortage and other problems: it’s someone else’s turn.’”