[Symposium 61] Ethnic diversity, psychiatric conditions, and transgressive behavior: Insights from cases in forensic mental health care

[SY-61-01] Exploring the impact of mandatory repatriation on cultural identity and pathways to recovery of migrant forensic psychiatric patients in a Dutch Centre for Transcultural Psychiatry.

*Charlotte Clous^1,2, Hannah Jongsma^1,2, Anniek Van Weeghel^5,6, Ria Reis^4,3, Wim Veling¹ (1.University Medical Centre Groningen (UMCG)(Netherlands), 2.Centre for Transcultural Psychiatry Veldzicht(Netherlands), 3.Leiden University Medical Centre (LUMC)(Netherlands), 4.Amsterdam institute for Global Health Development (AIGHD)(Netherlands), 5.University of Amsterdam (UvA)(Netherlands), 6.Arq Psychotrauma International(Netherlands))

Keywords:

cultural psychiatry,ethnography,repatriation,cultural identity,recovery

Forensic psychiatric patients with a migration background in the Netherlands face unique challenges when their offences lead to revocation of residence rights, often resulting in repatriation to countries that may feel as alien to them as to their Dutch care providers. This ethnographic study explores how patients in a Dutch forensic transcultural psychiatric facility navigate these imposed repatriation perspectives, focusing on the negotiation of cultural identity and its impact on pathways to recovery. Through hospital ethnography we have examined how sociocultural identification processes influence recovery among ethnic minority forensic inpatients with pre-existing psychotic disorders. The study highlights how treatment progress is hindered by limited social leave and structural ‘othering,’ at the intersection of criminal and migration law.. We discuss the role of discrimination and cultural identity as potential drivers of increased psychosis risk, extending beyond epidemiological frameworks to include lived experiences of inclusion and exclusion of people in closed forensic mental health care settings. Ethnic density theory frames how sociocultural inclusion can buffer against mental health deterioration, yet imposed multicultural environments and repatriation pressures limit possibilities for cultural expression. Our findings reveal complex patterns of cultural identity formation that challenge binary acculturation models and illustrate how vulnerable people display remarkable creativity, finding new ways to belong through cultural hybridization. By centering patients’ voices in their interactions with staff and institutional values, we provide insight into the challenges and opportunities for culturally sensitive forensic mental healthcare. These results underscore the need for personalized, context-based care that integrates cultural identity negotiation and the structural realities faced by migrant patients. The findings may inform adaptations to clinical tools like the Cultural Formulation Interview to better address the nuanced needs of this vulnerable group.