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 ◽  
...  

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.

1999 ◽  
Vol 26 (1) ◽  
pp. 20-43 ◽  
Author(s):  
MARK D. CUNNINGHAM ◽  
THOMAS J. REIDY

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nafiso Ahmed ◽  
Sally Barlow ◽  
Lisa Reynolds ◽  
Nicholas Drey ◽  
Fareha Begum ◽  
...  

Abstract Background Risk assessment and risk management are fundamental processes in the delivery of safe and effective mental health care, yet studies have shown that service users are often not directly involved or are unaware that an assessment has taken place. Shared decision-making in mental health systems is supported by research and advocated in policy. This systematic review (PROSPERO: CRD42016050457) aimed to explore the perceived barriers and enablers to implementing shared decision-making in risk assessment and risk management from mental health professionals’ perspectives. Methods PRISMA guidelines were followed in the conduct and reporting of this review. Medline, CINAHL, EMBASE, PsycINFO, AMED and Internurse were systematically searched from inception to December 2019. Data were mapped directly into the Theoretical Domains Framework (TDF), a psychological framework that includes 14 domains relevant to behaviour change. Thematic synthesis was used to identify potential barriers and enablers within each domain. Data were then matched to the three components of the COM-B model: Capability, Opportunity, and Motivation. Results Twenty studies met the eligibility criteria. The findings of this review indicate that shared decision-making is not a concept commonly used in mental health services when exploring processes of risk assessment and risk management. The key barriers identified were ‘power and best interest’ (social influences) and ‘my professional role and responsibility’ (social/professional role and identity). Key enablers were ‘therapeutic relationship’ (social influences) and ‘value collaboration’ (reinforcement). The salient barriers, enablers and linked TDF domains matched COM-B components ‘opportunity’ and ‘motivation’. Conclusion The review highlights the need for further empirical research to better understand current practice and mental health professionals’ experiences and attitudes towards shared decision-making in risk assessment and risk management.


Author(s):  
John Monahan

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.


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