Leave modalities in Flemish forensic psychiatric care and their associations with patient characteristics: A latent class analysis.

Leave modalities are an integral part of rehabilitation in forensic psychiatric care; however, empirical evidence on leave approvals is scarce. This study investigated the timing and reasons underlying leave approvals among 174 patients (95.4% male; mean age = 50.2 years) in resocialization units of high-security forensic psychiatric institutions in Flanders, Belgium, focusing on leave permits (up to 16 h) and leaves (up to 14 days). Analyses were conducted on the entire sample to identify general patterns, followed by latent class analysis (LCA) to group patients based on offenses, clinical indicators, and background characteristics. In total, 1012 leave permit applications and 64 leave applications were submitted. All patients had at least one leave permit application, while leave applications were recorded for only 41 patients. The first leave permits were requested after 2.8 years and approved after 3.5 years, whereas leaves were requested and approved later (4.4 and 5.2 years, respectively). Approval rates were high for leave permits (75.7%), but considerably lower for leaves (28.1%), and varied depending on the purpose and applicant. Applications initiated by institutions were far more likely to be approved (89.2-100%) than those initiated by patients or lawyers (13.3-20.9%). Latent class analysis identified four patient subgroups, revealing significant differences in approval rates across classes, but not in timing. This suggests that while institutional routines largely determine timing, approval decisions depend on patient characteristics, underscoring the need for more tailored decision-making.