Court-ordered psychiatric care for criminals is under strain as waitlist rises to 261
The Dutch forensic psychiatric system is increasingly gridlocked, with the waiting list for treatment rising to 261 people from 45 in 2020, admissions dropping to 118 new patients last year, a 28 percent decline compared with 2024, and average treatment duration increasing to about 10 years, roughly 1.5 years longer than in 2024. In 2025, an average of 1,683 patients were in TBS care, while clinics report growing bottlenecks in intake, treatment progression, and discharge, NOS reported.
TBS, short for terbeschikkingstelling, is a Dutch forensic measure imposed by a judge, not a prison sentence. It applies to offenders who committed a serious crime while suffering from psychiatric disorders that reduced their responsibility. The goal is treatment and risk reduction, with the aim of safe reintegration.
It can be imposed alongside a prison sentence of at least four years, and is ordered when there is a risk of reoffending. The two main forms are TBS with conditions and TBS with compulsory treatment in a secure clinic, the latter being the most restrictive form.
The system is under pressure at both entry and exit points. More people are being sentenced to TBS, but fewer are entering treatment, and those already inside are staying longer. A key bottleneck is the lack of “step-down” capacity: patients who are ready to leave high-security clinics often cannot move to supervised housing or lower-security facilities because of shortages, forcing them to remain in intensive care longer than medically necessary.
Clinics in places such as De Kijvelanden and Oostvaarderskliniek have expanded beds, and Veldzicht is adding capacity, but officials say this will not be sufficient to meet demand. In 2025, there were 85,661 leave permissions granted for patients; most passed without incident, with only 12 cases of late returns and no recorded escapes.
Hyacinthe van Bussel, director of De Rooyse Wissel and chair of TBS Nederland, said the system is struggling with risk thresholds and societal resistance to housing forensic patients in the community. He questioned whether the bar for progression has become too high, suggesting that excessive caution may be lengthening treatment times.
Against this backdrop, Corné H., a 30-year-old detainee, is near the top of the waiting list for placement in the Van Mesdag Clinic. He was convicted in a 2024 hostage-taking in Ede and has now been in detention for nearly 18 months while awaiting transfer to forensic psychiatric care. He is also linked to a Dec. 5, 2025 incident in which he took staff hostage at PI Vught and has repeatedly self-harmed while in custody.
His lawyers are demanding in a Tuesday appeal that the state place him immediately in a clinic. They argue that recent reports from two forensic psychologists indicate a continued high risk of further incidents. H. is currently held at PI Zaanstad and told the court he is coping “reasonably” under the circumstances while seeking clarity. Medical assessments indicate autism spectrum disorder, PTSD, and that he hears voices.
The state argues that immediate placement is not possible because of ongoing criminal proceedings related to the PI Vught incident, scheduled to be heard on July 20. The Van Mesdag Clinic generally does not admit patients who are still under active criminal investigation. Even if the case ends without a prison sentence or TBS order, placement may still take several months.
A ruling from the court is expected by July 7. In February, a judge ruled that Corné H. is not entitled to priority over other detainees awaiting placement.
