Forensic mental health in Europe: some key figures

Jack Tomlin (Coresponding Author), the experts of COST Action IS1302, Maris Taube (Member of the Working Group)

Research output: Contribution to journalArticlepeer-review

31 Citations (Scopus)
14 Downloads (Pure)


Purpose: While the number of forensic beds and the duration of psychiatric forensic psychiatric treatment have increased in several European Union (EU) states, this is not observed in others. Patient demographics, average lengths of stay and legal frameworks also differ substantially. The lack of basic epidemiological information on forensic patients and of shared indicators on forensic care within Europe is an obstacle to comparative research. The reasons for such variation are not well understood. Methods: Experts from seventeen EU states submitted data on forensic bed prevalence rates, gender distributions and average length of stay in forensic in-patient facilities. Average length of stay and bed prevalence rates were examined for associations with country-level variables including Gross Domestic Product (GDP), expenditure on healthcare, prison population, general psychiatric bed prevalence rates and democracy index scores. Results: The data demonstrated substantial differences between states. Average length of stay was approximately ten times greater in the Netherlands than Slovenia. In England and Wales, 18% of patients were female compared to 5% in Slovenia. There was a 17-fold difference in forensic bed rates per 100,000 between the Netherlands and Spain. Exploratory analyses suggested average length of stay was associated with GDP, expenditure on healthcare and democracy index scores. Conclusion: The data presented in this study represent the most recent overview of key epidemiological data in forensic services across seventeen EU states. However, systematically collected epidemiological data of good quality remain elusive in forensic psychiatry. States need to develop common definitions and recording practices and contribute to a publicly available database of such epidemiological indicators.

Original languageEnglish
Pages (from-to)109-117
Number of pages9
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number1
Publication statusPublished - Jan 2021
Externally publishedYes


  • Beds
  • Deinstitutionalization
  • Europe
  • Forensic mental health
  • Prevalence

Field of Science*

  • 3.3 Health sciences
  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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