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Ghent Group

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Meetings

2004   Ghent (Belgium)

2005   Stockholm (Sweden)

2006   Kopenhagen (Denmark)

2007   Munich (Germany)

2008   Nijmwegen (The Netherlands)

2009   Bridgend (Cardiff, Wales)

2010   Innsbruck (Austria)

2011   Antwerp (Belgium)

2012   Barcelona (Spain)

2013   Dublin (Ireland)

2014   London (UK)

2015   Budapest (Hungary)

2016   Vught  (The Netherlands)

2017   Vienna (Austria)

2018   Vaasa (Finland)

2019   Siena (Italy)

                                                

 

THE GHENT GROUP

16th Annual Meeting

Siena (Italy), 19th-21st September 2019 

 

 

 

 

15th Annual Ghent Group meeting 

Vaasa, Finland 20th-22nd September 2018 

 


Markku Eronen welcomed everyone to Vanha Vaasa – old Vaasa – about seven kilometres outside the modern city. Vanha Vaasa hospital celebrated the 250th of its foundation this year, although the present building was erected in about 1940, as part of recovery from a devastating fire in the region. After lunch, dates he and Allan Seppänen introduced us to the Finnish Forensic Mental Health System. There are two main secure hospitals in Finland – the other in Kuopio – and a university centre in Helsinki. 

 

 

The visitors – variously from Austria, Belgium, Germany, Ireland, Sweden and the UK – were impressed with the two wards visited, the most secure for men and the open unit, where staff and patients were welcoming. Physical security was not fearsomely visible, although patients in the high security unit could not leave the building and took exercise in the secure gardens. Patients, even in the high security area, retained use of mobile phones if they wished, mainly so that they could keep in contact with their families if they had them, and could also have access to the internet. Security breaches are rare and manageable, and the rest of us considered it important to take this information back to our secure services. None of the other country participants could report secure such access in their secure mental health services. One prominent difficulty in delivering services in a country with a small population (5.5 million) was apparent in that in each of the high security units – one for men and one for women – there was little option but to keep any person with severe disturbance and medication resistance in seclusion or segregation for long periods. The hospital had to be able to manage all patients without help from anywhere else. That said, most were making good progress through the system, with access to educational and occupational activities as well as opportunities for exercise. Psychological therapies were available and, this being Finland, even the high security wards had sauna facilities. 

 

In the evening, we were welcomed to an evening reception at the art gallery in Vaasa, in an exhibition room of particular interest for its documentation of a recent archaeological find of a group of bodies of women and children, centuries old, buried nearby and its artistic celebration of their life blood in laboratory style vessels.  

 

On Friday morning, Lindsay Thomson and Pamela Taylor led a discussion on outcome measures in forensic psychiatry. In brief, we explored the different needs in this respect for the individual patient and for service evaluation and monitoring as well as making the case for developments. Acknowledging the difficulties of developing a standard set for international use, given the considerable differences between our systems, there was nevertheless consensus on the desirability of attempts to do so, to facilitate comparative service evaluations. 

 

Damian Mohan introduced the Dundrum Toolkit (Kennedy et al, 2013 http://www.tara.tcd.ie/bitstream/handle/2262/67375/THE_DUNDRUM_TOOLKIT_V1%200%2026%20final%20copy.pdf;jsessionid=C172975A9844128046CF25D107E490AF?sequence=1 – et seq.)  Per-Axel Karlsson introduced a case to illustrate processes and pathways in Sweden - and to engage in some practical demonstration of the Dundrum toolkit. 

 

Kris Goethals presented an account of the aftermath of the Dutroux case some in Belgium, illustrating how cases which can affect the public mood may have an impact on service development and practice – within and beyond forensic psychiatry. 

The evening was spent at Kalles’ Inn in ceremonial sauna, sea dipping and feasting. Per-Axel eschewed the sea because, as yet, it remains too warm for ice formation! Markku congratulated the ‘softer’, more southerly living participants for braving the 12o.

 

Our final session on Saturday morning began with a case presented by Allan Seppänen to facilitate discussion about how the various systems would assess and manage a homicide by a man with an alcohol problem who had been drinking heavily before the offence, and amnesia for the offence. In all, he would get a thorough assessment, although not necessarily in inpatient conditions, to include cognitive assessments and probably brain imaging, and in all he would most likely be managed with clinical input, as necessary, while serving a prison sentence. 

 

Riittakerttu Kaltiala-Heino delivered the final academic session on adolescent and school massacre threats. School shootings in Finland in 1989, 2007 and 2008 partly triggered the concerns, but sometimes also young people present talking about the possibility or seeking weapons, so there is an opportunity for prevention. Her research into development and challenges to healthy development during adolescence is wide ranging, so from data and an understanding encompassing developmental disorders, gender dysphoria, bullying and the impact of changing patterns in social networks, she is well placed to study extremes of dysfunction, which include fantasised or actual mass violence. 

 

Kaltiala-Heino R, Lindberg N. Gender identities in adolescent population: methodological issues and prevalence across age groups. European Psychiatry (accepted for publication September 2018)  

 

Knaappila N, Marttunen M, Fröjd S, Lindberg N, Kaltiala-Heino R. Socioeconomic Trends in School Bullying Among Finnish Adolescents from 2000 to 2015. Child Abuse & Neglect (accepted for publication September 2018) 

 

Kaltiala-Heino R, Fröjd S, Marttunen M. Sexual harassment and emotional and behavioural symptoms in adolescence: stronger associations among boys than girls. Soc Psychiatry Psychiatr Epidemiol. 2016: 51(8):1193-201. doi: 10.1007/s00127-016-1237-0 

 

Oksanen A, Kaltiala-Heino R, Holkeri E, Lindberg N. School shooting threats as a national phenomenon: comparison of police reports and psychiatric reports in Finland. Journal of Scandinavian Studies in Criminology and Crime Prevention 2015 16:2, 145-159, DOI: 10.1080/14043858.2015.1101823 


Vaasa Ghent Group final discussion and planning 

Janet Parrott sent her good wishes and apologies for not being able to join this meeting. 

Simona and Giovanni Traverso also sent their apologies, but also the information that planning for next year’s Ghent group conference is well under way. Simona writes: 

 

I have already taken contacts with the Directors of two forensic institutions in Florence (Villa Guicciardini) and in Volterra (REMS of Volterra) who gave their ok to let the members of our group visit the places. I also have already taken contacts with the Congress Office of our University in Siena, to begin thinking about the organization of the sejour matters and other administrative questions that must be accomplished for the next year meeting, which might last from 26th to 28th September 2019 (if this time is ok for you). 


Several people present expressed a preference for retaining the conference timing of 3rd week of September, but all said that it should be possible to arrange their diary to manage the fourth weekend if this is best for our hosts and the facilities they need to access. 

 

A suggestion that the 2020 meeting should be in Edinburgh was welcomed. 

All present agreed to sharing emails with all other Ghent group members. 

 

Esperanza Gómez Durán continues to support the website, but has not been in touch recently. Members would like more information on the website – and would be keen to help if that is feasible from Esperanza’s point of view. PJT will ask about the current financial situation, and whether more funds are needed. If so, the next conference should include a ‘surcharge’ to cover these. 

 

Kris Goethals raised the question about supporting students with bursaries/free places. All agreed this would be desirable, but as many attendees are entirely self-funding, and we have deliberately resisted a bureaucracy and formal management structure probably not feasible at present. Options might include lobbying health boards, Ministries of Justice or professional organisations to help. With assured numbers above an agreed level, another surcharge to be pooled to fund a free place could work, but then the place would have to be advertised and the recipient selected it a visibly fair way. It was agreed that not decisions could be taken at present but we would return to consider this issue on future occasions. 

 

Several attendees would like formal educational/professional development credits from attending the meeting. Markku can provide certificates of attendance, but not officially badged University documents, as they need prior planning and the process is very bureaucratic. In general, the former will suffice for most needs. 

 

Several outcomes were proposed as arising out of this meeting. 

1. Lindsay Thomson had illustrated the research bureaucracy in Scotland during her presentation, and all present had had some experience of similar and recognised its power for inhibiting research. PJT agreed to take this forward as a possible session for a future meeting and/or a Ghent group publication. 

2. The session on outcomes was much appreciated. It was agreed to ask Lindsay Thomson to engage the group in continuing work on this as all were supportive of the effort to develop a common data set. Markku suggested linking it to some data held in a European depository, from an outcomes study originally developed by Rudi Mueller-Isberner. Norbert would be interested to support this. The possibility of engaging Joachim Sturrup from Sweden was also suggested. 

3. An editorial or paper on the impact of the Dutroux case and other service or law influencing cases in Europe was suggested. This has previously been a theme at the residential Seeon/Irsee seminars. 

 

PJT 30/09/2018 

The next Summer School will be at Munich and Kloster Seeon 5-9 August 2019 

The next Ghent group conference in Siena, 19th – 21st September 2019 

Siena 2019

 

 

 

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