In this article, we describe critical epidemiological trends in forensic psychiatric care in the German federal state of Baden-Württemberg. For some years, there has been a marked increase in the number of patients with psychoses and with a migration background in the high-security hospitals of Baden-Württemberg. We present a number of studies exploring hypotheses as to why this is the case. Taking into account a set of person-related and non-person (forensic system)-related variables, we suggest that rising treatment figures may be understood in terms of system variables rather than individual patient characteristics. Findings regarding predictors of treatment length and legal outcome, as well as characteristics of migrant patients and patients assigned to forensic aftercare, are discussed.
© 2020 John Wiley & Sons, Ltd.