scholarly journals Evidence-based rehabilitation in forensic psychiatry

2000 ◽  
Vol 176 (4) ◽  
pp. 320-323 ◽  
Author(s):  
Per Lindqvist ◽  
Jeremy Skipworth
Keyword(s):  
Risk Assessment ◽  
Psychiatric Rehabilitation ◽  
Future Research ◽  
Assessment Instruments ◽  
Methodological Issues ◽  
Rehabilitation System ◽  
Risk Research ◽  
Limited Application ◽  
Forensic Psychiatric ◽  
Current Risk

BackgroundThe extent to which forensic psychiatric rehabilitation alters an individual's level of risk is unclear.AimsTo highlight some essential features of a forensic psychiatric rehabilitation system, and to discuss risk assessment in this context to create a conceptual framework for risk research and practice.MethodThe applicability of risk assessment instruments to forensic psychiatric rehabilitation was examined. Core processes and elements considered essential in this type of rehabilitative work were reviewed.ResultsCurrent risk research has limited application to rehabilitation. Future research aimed at analysing forensic psychiatric rehabilitation will be hampered by the complexity of the treatment systems and the number of methodological issues relevant to this type of research.ConclusionsNovel research approaches are suggested to analyse further the risk factors and processes important in forensic psychiatric rehabilitation.

The psychology quadrant: an outcome measure based on the START risk assessment

2017 ◽  
Vol 19 (1) ◽  
pp. 14-22
Author(s):  
Matthew John Gill ◽  
Samantha Brookes
Keyword(s):  
Risk Assessment ◽  
Factor Structure ◽  
Psychiatric Rehabilitation ◽  
Principal Component ◽  
Future Research ◽  
Psychological Outcome ◽  
Content Type ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation ◽  
Outcome Tool

Purpose The purpose of this paper is to develop a psychological outcome tool which reflects the relationship between clusters of items on the Short Term Assessment of Risk and Treatability (START) risk assessment and different categories of psychological progress in male inpatient psychiatric services. Design/methodology/approach A principal component analysis (PCA) was conducted on data from 135 male psychiatric rehabilitation patients’ START risk assessments. Findings PCA identified four strength psychology quadrants which were explained by a five-factor structure and four vulnerability quadrants which were explained by a four-factor structure. The development of the psychology quadrant, its usefulness in establishing a treatment pathway and areas of future research are also discussed. Originality/value Developing accessible, transparent outcome measures using evidence-based practice is highly relevant within the field of mental health rehabilitation.

The Empirical Case for Pretrial Risk Assessment Instruments

2021 ◽  
pp. 009385482110416
Author(s):  
Sarah L. Desmarais ◽  
John Monahan ◽  
James Austin
Keyword(s):  
Risk Assessment ◽  
Race And Ethnicity ◽  
Scientific Evidence ◽  
Criminal Activity ◽  
System Change ◽  
Future Research ◽  
Assessment Instruments ◽  
Pretrial Release ◽  
Pretrial Detention ◽  
Rigorous Research

Pretrial risk assessment instruments are used in many jurisdictions to inform decisions regarding pretrial release and conditions. Many are concerned that the use of pretrial risk assessment instruments may be contributing to worsened, not improved, pretrial outcomes, including increased rates of pretrial detention and exacerbated racial disparities in pretrial decisions. These concerns have led prominent organizations to reverse their position on the role of pretrial risk assessment instruments in pretrial system change. Reforms that centered on their use have been rolled back or have failed to be implemented in the first place. However, the scientific evidence behind these concerns is lacking. Instead, the findings of rigorous research show that the results of pretrial risk assessment instruments demonstrate good accuracy in predicting new criminal activity, including violent crime, during the pretrial period, even when there are differences between groups defined by race and ethnicity. Furthermore, the scientific evidence suggests they can be an effective strategy to help achieve pretrial system change, including reducing pretrial detention for people of color and white people, alike, when their results are actually used to inform decision-making. In this article, we review the scientific evidence in relation to three primary critiques of pretrial risk assessment instruments, namely, that their results have poor accuracy and are racially biased and that their use increases pretrial detention rates. We also provide recommendations for addressing these critiques to ensure that their use supports, rather than detracts from, the goals of pretrial reform and articulates an agenda for future research.

A medico-judicial framework for the rehabilitation of forensic psychiatric patients in Zimbabwe

2015 ◽  
Vol 17 (2) ◽  
pp. 134-148 ◽  
Author(s):  
VIRGININIA DUBE-MAWEREWERE
Keyword(s):  
Social Workers ◽  
Psychiatric Patients ◽  
Public Attitudes ◽  
Psychiatric Rehabilitation ◽  
Future Research ◽  
Content Type ◽  
The Public ◽  
Forensic Psychiatric Patients ◽  
Service Staff ◽  
Forensic Psychiatric

Purpose – The purpose of this paper is to develop a medico-judicial framework for rehabilitation of forensic psychiatric patients in Zimbabwe. Design/methodology/approach – Grounded theory of the Charmaz (2006, 2014) persuasion was used. An exploratory qualitative design was utilised. The theoretical framework that was used as a point of departure was Pierre Bourdieu’s conceptual canon. Participants were purposefully and theoretically sampled. These included the judiciary, patients, patients’ family, psychiatrists, nurses, social workers, experts in forensic psychiatric practice. They were 32 in total. Findings – The findings reflected a need to realign the dislocation and dissonance between and within the fields of the prison system, medical system, and the judiciary. The realignment was done by co-constructing a therapeutic jurisprudent medico-judicial framework for rehabilitation of forensic psychiatric patients in Zimbabwe with participants who were stakeholders in forensic psychiatric rehabilitation. Research limitations/implications – The study was focused on male forensic psychiatric patients rehabilitation and not on female forensic psychiatric patients because there were important variables in the two groups that were not homogenous. However, it is possible that including females in the study could have added perspective to the study. This also limits the generalisation of findings beyond the male forensic psychiatric participants. Services beyond the experience of participants translate to the notion that findings cannot be generalised beyond the parameters of the study. Future research and service evaluation and audit need to be considered. The study findings focused on the “psychiatric” aspect and did not emphasise the “forensic” aspect of the service delivery service. Future research may need to feature physical provisions and progression pathways with reference to “forensic” risk reduction as a parallel goal. Practical implications – The study calls for the following: Transformation of the medico-judicial system, adjusting legislation and restructuring of the public service; changing of public attitudes to enable implementation of the medico-judicial framework; there is need for a step by step process in the implementation of the framework in which training needs of service staff, social workers, community leaders and key stakeholders will need to be addressed; the proposed changes presented by the model will require cultural, financial and infrastructural shifts. Social implications – There is need for policy makers to re-enfranchise or rebrand forensic psychiatric rehabilitation services in Zimbabwe. This could positively involve the marketing of forensic psychiatric rehabilitation to the stakeholders and to the public. This is projected to counter the stigma, disinterest and disillusionment that run through both professionals and public alike. This will foster a therapeutic jurisprudence that upholds the dignity and rights of forensic psychiatric patients. Originality/value – This work is an original contribution to forensic psychiatry in Zimbabwe. Research in that area is prohibitive because of the complexity of processes that are followed. This research is therefore ground breaking.

scholarly journals Use of risk assessment instruments to predict violence in forensic psychiatric hospitals: a systematic review and meta-analysis

2018 ◽  
Vol 52 ◽  
pp. 47-53 ◽  
Author(s):  
Taanvi Ramesh ◽  
Artemis Igoumenou ◽  
Maria Vazquez Montes ◽  
Seena Fazel
Keyword(s):  
Risk Assessment ◽  
Performance Measures ◽  
Predictive Accuracy ◽  
Psychiatric Inpatient ◽  
Psychiatric Hospitals ◽  
Assessment Tools ◽  
Assessment Instruments ◽  
Predictive Values ◽  
Meta Regression ◽  
Forensic Psychiatric

AbstractBackground and Aims:Violent behaviour by forensic psychiatric inpatients is common. We aimed to systematically review the performance of structured risk assessment tools for violence in these settings.Methods:The nine most commonly used violence risk assessment instruments used in psychiatric hospitals were examined. A systematic search of five databases (CINAHL, Embase, Global Health, PsycINFO and PubMed) was conducted to identify studies examining the predictive accuracy of these tools in forensic psychiatric inpatient settings. Risk assessment instruments were separated into those designed for imminent (within 24 hours) violence prediction and those designed for longer-term prediction. A range of accuracy measures and descriptive variables were extracted. A quality assessment was performed for each eligible study using the QUADAS-2. Summary performance measures (sensitivity, specificity, positive and negative predictive values, diagnostic odds ratio, and area under the curve value) and HSROC curves were produced. In addition, meta-regression analyses investigated study and sample effects on tool performance.Results:Fifty-two eligible publications were identified, of which 43 provided information on tool accuracy in the form of AUC statistics. These provided data on 78 individual samples, with information on 6,840 patients. Of these, 35 samples (3,306 patients from 19 publications) provided data on all performance measures. The median AUC value for the wider group of 78 samples was higher for imminent tools (AUC 0.83; IQR: 0.71–0.85) compared with longer-term tools (AUC 0.68; IQR: 0.62-0.75). Other performance measures indicated variable accuracy for imminent and longer-term tools. Meta-regression indicated that no study or sample-related characteristics were associated with between-study differences in AUCs.Interpretation:The performance of current tools in predicting risk of violence beyond the first few days is variable, and the selection of which tool to use in clinical practice should consider accuracy estimates. For more imminent violence, however, there is evidence in support of brief scalable assessment tools.

Evaluation of the Reliability and Validity of Two Clinician- Judgment Suicide Risk Assessment Instruments

Crisis ◽  
2010 ◽  
Vol 31 (2) ◽  
pp. 76-85 ◽  
Author(s):  
Prachi Kene-Allampalli ◽  
Joseph D. Hovey ◽  
Gregory J. Meyer ◽  
Joni L. Mihura
Keyword(s):  
Risk Assessment ◽  
Factor Analysis ◽  
Internal Consistency ◽  
Suicide Risk ◽  
Reliability And Validity ◽  
Future Research ◽  
Assessment Instruments ◽  
Suicide Risk Assessment ◽  
Starting Point ◽  
Clinician Judgment

Background: This study evaluates the psychometric properties and factor structure of two clinician-judgment suicide risk assessment instruments – the Suicide Assessment Checklist developed by Yufit and the other developed by Rogers. Methods: As an archival study, 85 client records were obtained through a university psychology clinic. Results: Internal consistency was high for only one subscale of the Yufit checklist after deleting items for factor analyses, whereas internal consistency was high for the overall Rogers checklist after deleting items. Interrater reliability was excellent for both instruments. Both checklists correlated with self-reported suicidality on the Personality Assessment Inventory. Preliminary analyses indicated that data from the Yufit checklist are unsuitable for factor analysis, whereas factor analysis of the Rogers checklist identified one depressive factor. Conclusions: These findings provided evidence supporting the reliability and validity of the Rogers checklist. The findings also provided a good starting point for future research of the Yufit checklist.

scholarly journals Is Knowledge Contagious? Diffusion of Violence-Risk-Reporting Practices Across Clinicians’ Professional Networks

2021 ◽  
pp. 216770262095479
Author(s):  
Yanick Charette ◽  
Ilvy Goossens ◽  
Michael C. Seto ◽  
Tonia L. Nicholls ◽  
Anne G. Crocker
Keyword(s):  
Risk Assessment ◽  
Assessment Tools ◽  
Assessment Instruments ◽  
Assessment Practices ◽  
Violence Risk ◽  
Professional Networks ◽  
Reporting Practices ◽  
Risk Assessment Tools ◽  
Knowledge Practice ◽  
Forensic Psychiatric

The knowledge–practice gap remains a challenge in many fields. Health research has shown that professional networks influence various aspects of patient care, including diffusion of innovative practices. In the current study, we examined the potential utility of professional networks to spread the use of violence-risk-assessment tools in forensic psychiatric settings. A total of 6,664 reports, written by 708 clinicians, were used to examine the effect of clinicians’ use of risk-assessment tools on subsequent reports by other clinicians with whom they share patients. Results show that professional networks serve as an important channel for the spread of assessment practices. Simulation of a continuing education program showed that targeting more influential clinicians in the network could be 3 times more efficient at disseminating best practices than randomly training clinicians. Decision-makers may consider using professional networks to identify and train influential clinicians to maximize diffusion of the use of risk-assessment instruments.

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