Neuropsychology can enhance violence risk assessment: Opportunities and limitations for mental health professionals

2013 ◽  
Author(s):  
Casey LaDuke ◽  
Kirk Heilbrun ◽  
David DeMatteo
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Violence Risk ◽  
Violence Risk Assessment

scholarly journals Violence Risk Assessment Practices in Denmark: A Multidisciplinary National Survey

2015 ◽  
Vol 21 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Louise Hjort Nielsen ◽  
Sarah van Mastrigt ◽  
Randy K. Otto ◽  
Katharina Seewald ◽  
Corine de Ruiter ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Risk Management ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Assessment Practices ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Risk Monitoring ◽  
Professional Disciplines

Abstract With a quadrupling of forensic psychiatric patients in Denmark over the past 20 years, focus on violence risk assessment practices across the country has increased. However, information is lacking regarding Danish risk assessment practice across professional disciplines and clinical settings; little is known about how violence risk assessments are conducted, which instruments are used for what purposes, and how mental health professionals rate their utility and costs. As part of a global survey exploring the application of violence risk assessment across 44 countries, the current study investigated Danish practice across several professional disciplines and settings in which forensic and high-risk mental health patients are assessed and treated. In total, 125 mental health professionals across the country completed the survey. The five instruments that respondents reported most commonly using for risk assessment, risk management planning and risk monitoring were Broset, HCR-20, the START, the PCL-R, and the PCL:SV. Whereas the HCR-20 was rated highest in usefulness for risk assessment, the START was rated most useful for risk management and risk monitoring. No significant differences in utility were observed across professional groups. Unstructured clinical judgments were reported to be faster but more expensive to conduct than using a risk assessment instrument. Implications for clinical practice are discussed.

Don't Confuse me with the Facts

1999 ◽  
Vol 26 (1) ◽  
pp. 20-43 ◽  
Author(s):  
MARK D. CUNNINGHAM ◽  
THOMAS J. REIDY
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Criminal History ◽  
Violence Risk ◽  
Illusory Correlation ◽  
Future Dangerousness ◽  
Patterns Of Behavior ◽  
Effects Of Aging

The life and death context of a capital risk assessment requires a comprehensive forensic evaluation. Mental health professionals routinely testify regarding future dangerousness in capital proceedings but too often limit assessment to DSM-IV diagnoses and criminal history without integrating empirical and actuarial data from other sources. Given the grave magnitude of a capital risk assessment both for the defendant and society, methodological and conceptual errors of this type must be avoided. This article will describe violence risk-assessment errors made by mental health professionals testifying at capital sentencing. Observed errors include inadequate reliance on base rates, failure to consider context, susceptibility to illusory correlation, failure to define severity of violence, overreliance on clinical interview, misapplication of psychological testing, exaggerated implications of antisocial personality disorder, ignoring the effects of aging, misuse of patterns of behavior, neglect of preventive measures, insufficient data, and failure to express the risk estimate in probabilistic terms.

Predictions of Violence

2018 ◽  
pp. 143-157
Author(s):  
John Monahan
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Criminal Justice ◽  
Central Issue ◽  
Violence Risk ◽  
Historical Account ◽  
Violence Risk Assessment ◽  
Comprehensive Review ◽  
Psychology And Law ◽  
Criminal Justice Systems

This chapter presents an historical account of the emergence of violence risk assessment as a central issue in what were portrayed as reforms of the mental health and criminal justice systems in the 1970s. The author traces his own involvement in the nascent field of psychology and law to his writing the first comprehensive review of research on the validity of violence risk assessment. The chapter then details the major theoretical, empirical, and policy strides that characterized violence risk assessment as it matured over the next several decades. The author concludes by reflecting on several issues whose resolution has proved elusive.

How do mental health professionals deal with uncertainty in suicide risk assessment?

2011 ◽  
Vol 26 (S2) ◽  
pp. 1628-1628
Author(s):  
K. Manley ◽  
J. Beezhold
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Suicide Risk ◽  
List Type ◽  
Suicide Risk Assessment ◽  
Individual Level ◽  
Clinical Scenarios ◽  
Image Position

IntroductionSuicide risk-assessment forms a significant part of the workload of mental health professionals (MHPs). There is much research regarding efficacy of different methods/scales of suicide risk-assessment, and effects of formal training on risk-assessment. To date, there is little investigation into how approach to risk-assessment varies amongst professionals on an individual level, or how MHPs react when confronted by lack of information.ObjectiveThis study evaluated how MHPs respond to uncertainty when assessing suicide risk.Methods720 MHPs were given 10 clinical scenarios and asked to assess suicide risk in each case. The scenarios were a mixture of high, medium and low risk cases. In addition, there were scenarios where information provided was incomplete or ambiguous. Subjects graded suicide risk-severity from 1–10 (1 = low, 10 = high).ResultsThe simple scenarios produced a predictable consensus of opinion amongst MHPs. The ambiguous scenario produced three distinct response peaks (Fig. 1) at low, medium, and high risk.Fig. 1[Fig 1]ConclusionsAmbiguous suicide risk separates MHPs into three responder groups:1.‘don’t know’2.more cautious, assumes higher risk3.less cautious, assumes lower risk.This has implications for suicide risk training. Further research is required to fully understand why individuals respond in different ways to suicide risk scenarios.

scholarly journals Assessment of violence risk in 440 psychiatric patients in China: examining the feasibility and acceptability of a novel and scalable approach (FoVOx)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaoling Zhong ◽  
◽  
Rongqin Yu ◽  
Robert Cornish ◽  
Xiaoping Wang ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Risk Assessment ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Psychiatric Patients ◽  
Clinical Decision ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Risk Categories

Abstract Background Violence risk assessment is a routine part of clinical services in mental health, and in particular secure psychiatric hospitals. The use of prediction models and risk tools can assist clinical decision-making on risk management, including decisions about further assessments, referral, hospitalization and treatment. In recent years, scalable evidence-based tools, such as Forensic Psychiatry and Violent Oxford (FoVOx), have been developed and validated for patients with mental illness. However, their acceptability and utility in clinical settings is not known. Therefore, we conducted a clinical impact study in multiple institutions that provided specialist mental health service. Methods We followed a two-step mixed-methods design. In phase one, we examined baseline risk factors on 330 psychiatric patients from seven forensic psychiatric institutes in China. In phase two, we conducted semi-structured interviews with 11 clinicians regarding violence risk assessment from ten mental health centres. We compared the FoVOx score on each admission (n = 110) to unstructured clinical risk assessment and used a thematic analysis to assess clinician views on the accuracy and utility of this tool. Results The median estimated probability of violent reoffending (FoVOx score) within 1 year was 7% (range 1–40%). There was fair agreement (72/99, 73% agreement) on the risk categories between FoVOx and clinicians’ assessment on risk categories, and moderate agreement (10/12, 83% agreement) when examining low and high risk categories. In a majority of cases (56/101, 55%), clinicians thought the FoVOx score was an accurate representation of the violent risk of an individual patient. Clinicians suggested some additional clinical, social and criminal risk factors should be considered during any comprehensive assessment. In addition, FoVOx was considered to be helpful in assisting clinical decision-making and individual risk assessment. Ten out of 11 clinicians reported that FoVOx was easy to use, eight out of 11 was practical, and all clinicians would consider using it in the future. Conclusions Clinicians found that violence risk assessment could be improved by using a simple, scalable tool, and that FoVOx was feasible and practical to use.

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