An increase in substance misuse rather than other mental disorders has led to increased forensic treatment rates in the Czech Republic.

It is suggested that limited access to appropriate care forces psychiatric patients towards forensic treatment or to the prison system. According to our data, the number of prisoners, the number of hospitalized psychiatric patients (from 1987 to 2007), the number of court ordered forensic treatments in the Czech Republic (from 1991 to 2007), and the rate of people in psychiatric and sex offender forensic treatment has remained constant. However, an increase (162%) in number of treatments imposed for abusing illicit drugs did occur during this period. This increase contributed to the correlation between both the number of sentences given for protective treatment and the number of all sentenced persons (Pearson cor. 0.647, p < 0,001) and the number of prisoners (Pearson cor. 0.798, p < 0,001). The analysis of all admissions to a forensic facility from a catchment area of 1,260,318 inhabitants shows no increase in number of admission between 2002 and 2007. The same data prove that the number of patients ordered to psychiatric and sexology treatment remained steady and did not reflect changes in the number of prisoners or number of hospitalized patients. This could be explained by a high number of psychiatric hospitalizations protecting the patients from deteriorating to criminal behaviour.