Background: For some ten years now the term ‘confused persons’ has gained prominence in the Netherlands. Introduced by the police, it gathered attention due to rising numbers of police calls, to become entangled with broader sentiments of unsafety due to serious incidents with people with mental disorders. Mental health services have struggled with the term, since it is no diagnosis and it often leads to misunderstandings and controversies.

Aim: To explain 1. the origins of the term, 2. the numbers, 3. the impact on police, juicidal system and society, 4. possible explanations for misunderstood behaviour, and 5. leads for both health and safety services.

Method: Overview of recent sources and previous own research.

Results: It is important to differentiate across type and severity of behaviours, between people with (serious) social difficulties and people with severe mental disorders, so they are not needlessly medicalized (too much professional involvement), legalized (resulting in punishment) or normalized (too little professional involvement). More attention is needed for the ‘normal life’ of people that are faced with intensive and often restrictive professional services, so more differentiated housing, working and living becomes available. Last, for some people it is necessary to maintain (professional) surveillance and/or guidance for their entire lives, both from a safety and human perspective.

Conclusion: Confused or misunderstood behaviour is a broad concept that includes many causes with varying causes: from micro-organizational and collaboration problems to (macro) the social structure and culture in society. Focusing on a few well-defined groups, collaboration and system problems can be useful. The existing problems are not easy to solve and require sustainable investments in human willingness and expertise.

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