Elien Neimeijer

8 Lauren Lauren is 23 years old when she gets admitted to a high intensive care unit at Trajectum, a Dutch secure forensic treatment facility that specialises in the treat- ment of adults with mild intellectual disabilities (MID) or borderline intellectual functioning (BIF), severe challenging behaviour, mental health problems, and/or a history of substance abuse. There has been an extensive history of professional support since birth. She is the youngest child in a family with four children. Her father is regularly detained because of criminal activities. Lauren’s mother works as a prostitute and is addict- ed to drugs. She is also regularly detained for drug-related offences. The family lives in a trailer when Lauren is born. Her parents argue a lot involving physical violence and are unable to take care of their children. Two months after her birth, Lauren is placed out of home and cared for in a foster family. This is where she initially devel- ops well. From time to time she has contact with her biological father and siblings. Lauren visited a school for special education for children with learning disorders and behavioural problems where she needs a lot of guidance. When Lauren is ten years old, she is sexually abused by her foster brother. In the same year, her biological sister and grandmother die. After this, Lauren shows more problematic behaviour. She is aggressive, shows self-injury, comes into contact with the police for vandalism and runs away from the foster family several times. After this it goes downhill with Lauren. She is increasingly aggressive, self-injures more often and more severely, destroys objects, screams and spits at her foster parents. Sometimes she is depressed and suicidal and indicates she suffers from voices inside her head. Her mood changes quickly. After an outburst of anger, she regrets her behaviour, feels bad and injures herself. Lauren receives outpatient youth care. When Lau- ren is twelve years old, she attends a school for secondary special education. Soon after, her behaviour becomes unmanageable. She runs from the classroom into the street, beats teachers, cuts herself and pounds her head against the wall. There are many conflict situations in which Lauren is no longer approachable. At the age of thirteen, she gets admitted to residential youth care where she is frequently transferred to more closed wards in various institutions because of risky behaviour such as arson, aggression towards social workers, serious self-harm and suicidal behaviour. In between admissions, she stays in the foster family, where several ag-