Elien Neimeijer

9 Introduction In the Netherlands, there are more individuals like Lauren with mild intellectual disability (MID; IQ 50–70) or borderline intellectual functioning (BIF; IQ 70–85) who have (severe) mental health problems or challenging behaviour, in combination with a range of problems in different areas of life. It concerns individuals who lost their grip on life, who cannot take care of themselves, who do not ask for help or even refuse help, who are difficult to stabilise and frequently end up in crisis situations. Many are depend- ent on alcohol and/or drugs and exhibit aggressive or criminal behaviour (Neijmeijer, 2020). In addition, socioeconomic problems regularly co-exist such as poverty, debts, unemployment, homelessness, relatively frequent hospitalisation, loneliness and vulner- ability (Woittiez, Eggink, Putman, & Ras, 2018). Lives, like Lauren’s, are characterised by fragmentation: lack of social and adequate professional support, problems at school, no job or meaningful activities, and multiple unsuccessful treatments. These problems are not only related to the persons themselves, but also pertains to an increasingly complex society that places high demands on their cognitive, social, emotional and adaptive skills (Didden, Troost, Moonen, & Groen, 2016). This target group is overrepresented in Dutch mental healthcare, prisons, forensic care (Kaal, Smits, & Vrij, 2017; Mosk & Degraeve, 2019), and addiction centers (Luteijn, gressive incidents occur. Among other things, she threatens her foster parents with a knife. She also uses alcohol and drugs from the age of sixteen. At the age of nineteen, Lauren commits arson and assault several times and was admitted by means of a TBS order (in Dutch: Terbeschikkingstelling: “disposal to be treated on behalf of the state”), as she was considered not to be legally accountable for her crimes because of her MID in combination with severe psychopathology. At first she stayed at a prison and a regular forensic treatment facility. Here, the support and treatment did insufficiently account for her special needs due to her MID in combination with severe mental health problems. Lauren was secluded in a locked room for almost every day of the year in combination with coercive meas- ures like psychical restraint (whereby one or more sociotherapists held her) and involuntary medication. For this reason, she was referred to Trajectum.