Elien Neimeijer

26 of substance use. Comorbidity is high: most of the participants were diagnosed with more than one disorder, not including MID-BIF. For most of the participants the type of problem behaviour was the reason for admittance. Most of the participants were admit- ted because of externalizing behaviour problems (i.e.. aggression or a sexual offense) and/ or internalizing problems (like self-injurious behaviour and suicide attempt) (Delforterie, Hesper, & Didden, 2020). Participants were placed in the facility under criminal law or civil law. In the Netherlands, individuals who have committed a serious crime and are not legally accountable due to a mental disorder are sentenced by court to detention under hospital orders. This measure is not a punishment but an entrustment act for individuals with mental disorders which aims to protect society against the risk of recidivism trough in- carceration and treatment. Treatment goals of participants placed under civil law include stabilization and referral to regular mental health care. These participants are in need of intensive care in a secure setting due to severe behaviour and mental health problems, similar to participants placed under criminal law in terms of required intensity of treat- ment and level of security. The treatment duration in both cases is rarely shorter than two years and can last ten years or more, depending on the participants’ legal status and risk of (re)offending. The facility consists of 58 groups, and the modal ward size is 8 beds. The mean treatment duration at Trajectum is two years and four months, although this is largely dependent on the participants’ legal status and risk level. During treatment, participants move to wards with different levels of restrictions. Participants of this sample resided on wards which had different security levels; 59% of the participants resided on a low secure ward, 20% of the participants resided on a medium secure ward and 21% of the partici- pants resided on a high secure ward. Procedure Data were collected in the context of routine monitoring of the ward’s climate within the facility. The study received approval from the local institutional review board. Each year, participants who resided in the facility were individually interviewed and completed the GCI. For the purpose of exploring psychometric properties of the instrument, only data from the first wave were used which were collected in March and April 2016. Participa- tion was on a voluntary basis. The researcher gave oral and written information to par-