Abuse in care services for former inmates: drug trafficking, threats and false statements

“There is vandalism, threats, drug trafficking, noise pollution and people you dare not pass by because they talk about stabbing.” For example, a resident outlines the complex on Geert Grootestraat in Zwolle, where several residents receive forensic treatment. This is help for people with a criminal record who also have an abuse or disorder. They receive mandatory supervision to prevent them from returning to crime.

The question is whether it will go well in Zwolle. The resident – who does not want to be named for fear of threats – finds it uncomfortable to see how fellow residents, who, however, want to move on, get in trouble again. “I see people here who want to take the last step to a normal life, but who slip off because of all the alcohol and drugs that are here.”

Not only in Zwolle, there are such signs of problems with the care of former prisoners, according to research from RTL Nieuws. In Hoensbroek, for example, a drug dealer even lived in the building of an institution.

Drugs increase the risk

“It’s like placing a mocha lover in a shop with mocha cakes. The temptation is very great,” says professor of forensic mental health care Chijs van Nieuwenhuizen from Tilburg University. The target group for forensic medicine is vulnerable and alcohol and drugs are attractive, the professor says.

“If drugs are very easy to get there, then you have to be very strong not to use drugs,” adds forensic psychiatry professor Robbert-Jan Verkes from Radboud University. “And it is precisely this drug use that poses such a high risk of criminal behavior.”

What is forensic treatment?

Forensic treatment is special care for a person with a criminal record who needs extra guidance. For example, due to an addiction, an intellectual disability or a mental illness. The care is imposed as a measure by a judge or the prosecution with a view to a safe return to society.

A large proportion of the ex-prisoners with forensic drugs make the mistake again. The purpose of mandatory treatment is to prevent this. This study did not look at the most well-known form of forensic treatment, namely that of TBS clinics, but at private providers of outpatient counseling or nursing homes.

46 healthcare providers stand out

RTL Nieuws has screened all more than 160 providers of forensic treatment, which will be under contract with the ministry in 2022. In more than a quarter of these (46 in total) something striking is going on; and it’s not just about drug problems, violence or threats.

It is also, for example, sky-high profits with peaks of up to 30 percent of revenue. Or directors who award themselves bonuses of sometimes hundreds of thousands a year. Monitoring reports also include poor care, poor hygiene, unqualified staff and other serious incidents.

Almost three quarters of the companies have not been visited at all by the Danish Health and Youth Care Authority (IGJ) in the last three years, the public database with supervisory reports shows. The research editorial staff spoke with various residents and local residents, (former) employees and other parties involved. Many of them want to remain anonymous for fear of threats.

Threat, destruction, intimidation

It seemed such a fantastic project: young people, people in need of care and former prisoners working together under one roof in Zwolle for a bright future. The practice is more unruly, says councilor Silvia Bruggenkamp from the local political party Swollwacht. She talked to the residents and was shocked.

“There are huge inconveniences. It is about drug use, drug trafficking, arms trafficking, threats – sometimes even death -, destruction, intimidation. It is very serious. The municipal administration in Zwolle has indicated that there is a continuing worrying situation. with sometimes very serious nuisances. That says a lot. “

At the care institution Op Mezelf in Hoensbroek, a drug dealer even lived among the clients for forensic treatment. The dealer is now gone, but councilor Peter van Zutphen (SP) is not reassured. Partly because the institution took dozens of apartments into use in a neighborhood that already had many problems.

“How do you get it in your head to fill sixty apartments there at once with people who also have the necessary problems. Then I really wonder what the judgment of such a care institution is.”

Bad example

According to Professor Verkes, it is ‘very worrying’ that there appear to be institutions where things are not in order. “Because those involved need an environment that is reliable, where agreements are complied with. Of course, they also have a hard time with that. They need a good example.”

Associate Professor of Health Law André den Exter from Erasmus University condemns the fact that some providers make significant profits and that administrators are paid generous bonuses, which raises the question of whether there is sufficient attention to the quality of treatment. “It may be legally possible to contract with healthcare providers who award dividend payments to directors, but that should never be accepted by the judiciary.”

It is noteworthy that a number of institutions are no longer welcome in different municipalities. Due to suspicion of fraud or poor care, the municipalities closed the tap for, for example, youth care or social assistance. These institutions then simply received a contract from the Ministry of Justice and Security.

The research editors at RTL Nieuws found several examples of this. Den Exter: “It is socially very questionable that care providers with malpractice can simply continue their practice in the Ministry of Justice.”

In March this year, the Court of Auditors, which examines whether the state uses public funds correctly, found that the Ministry of Justice has far too little insight into forensic medicine. It is therefore impossible to check whether the money has been spent correctly. In response to the findings of RTL Nieuws and the Court of Auditors, forensic experts would like further investigations to be carried out.

‘Quick action’

“And as soon as possible,” Verkes clarifies. Van Nieuwenhuizen has repeatedly quarreled over improvements. “I have been in many task force groups over the last 22 years and often hoped that things would get better. But too little is changing and it is taking too long. Hopefully this study is a moment that the ministry will look into. The Ministry of Justice and Security must make demands. “

Justice is even legally obligated to work with it, says health law expert Den Exter. “After all, this is a vulnerable group of care users for whom the Ministry of Justice is responsible. It thus creates obligations in relation to the care offered.”

Half a million too much declared

Although the prosecution already labeled them unreliable in 2020, health institution 4 Your Care from Arnhem received a new contract from the Ministry of Justice and Security in 2022 for the provision of forensic care.

Remarkably, the Ministry of Justice did not conclude much later, after an audit, that in 2019, more than 5,000 hours of care had been declared, which were not delivered. 4 Your Care had to repay an amount of 512,051 euros. The company went bankrupt in April.

The ministry acknowledges problems

In a response to the RTL Nieuws survey, the Ministry of Justice and Security acknowledges that there are problems with various health providers. “RTL’s research confirms the importance of the improvements being worked on.”

These improvements include a more comprehensive team performing statement verification. In the past year, 36 healthcare providers have been checked. In ten cases, erroneous declarations were established for a total amount of 6.5 million euros. Some providers are still under contract. The ministry will not say how many there are. “A certain amount of misrepresentation can occur without it being a reason to lose confidence in an institution.”

The ministry says it is aware that municipalities no longer want to cooperate with some providers. “Apparently they’re making a different decision,” a spokesman said. However, the Ministry of Justice wants data to be shared more easily so that there is more insight into suspected fraud and abuse. “If there are a lot of signals from other financiers such as municipalities about certain providers, it will be a good reason to carry out extra checks with such a provider.” We are also working on better quality requirements.

‘Has intervened after escalation’

The four carers at the Geert Groote complex in Zwolle (Humanitas-DMH, Salvation Army, Perspektiev and Philadelphia) say they intervened in cooperation with the municipality and the police when the situation escalated. The situation is now under control, officials said.

Nursing home Op Mezelf in Hoensbroek confirms that there were drug problems in a resident who received forensic treatment. The institution says it has informed the Ministry of Justice and states that things are now in order again. “Since the one case, there has been no drug-related offense in the apartments.”

accountability

For this research, the research editors of RTL Nieuws looked at all health institutions that had a contract with the Ministry of Justice and Security from 2022. These are providers of forensic medicine in the form of nursing homes or guidance in the home (outpatient).

In total, more than 160 companies were surveyed. These companies looked at annual reports, annual accounts and control reports, among other things. In addition, where relevant, municipal council documents, court judgments and previous appearances in the media were also reviewed. The research editorial staff also spoke to residents, local residents, former employees and institutions themselves.

Many people that RTL Nieuws has spoken to only dare to tell their story anonymously for fear of reprisals. Where possible, their stories were tested by authorities such as police and municipalities. The results of the study were also presented to several experts with expertise in, among other things, forensic medicine, psychiatry, health law and bookkeeping.

Tips

Do you have any tips on abuse in (judicial) care? Let the research editors know via research@rtl.nl.

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