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Risk assessment instruments in clinical practice.

Gilles Côté1, Anne G Crocker, Tonia L Nicholls

  • 1Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec. gilles.cote@uqtr.ca

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PubMed
Summary
This summary is machine-generated.

Risk assessment tools like the Historical-Clinical-Risk Management-20 (HCR-20) are underutilized in hearings for individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD), indicating a gap between research and practice.

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Area of Science:

  • Forensic Psychiatry
  • Clinical Psychology
  • Risk Assessment

Background:

  • The Historical-Clinical-Risk Management-20 (HCR-20) is a widely validated instrument for violence risk assessment.
  • Individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) undergo review board hearings to determine release or detention.

Purpose of the Study:

  • To investigate the extent to which HCR-20 items are incorporated into review board hearings for NCRMD individuals.
  • To identify discrepancies between research-based risk assessment and clinical practice in forensic settings.

Main Methods:

  • A comparative analysis was conducted between clinician risk assessments presented at review board hearings and research team assessments using the HCR-20.
  • Data were collected from 96 men in Quebec's forensic and civil psychiatric hospitals between 2004 and 2006.

Main Results:

  • Few HCR-20 risk factors were referenced in clinical reports, hearing discussions, or disposition justifications.
  • The study found limited integration of validated risk assessment tools into the formal hearing process.

Conclusions:

  • A significant gap exists between established research evidence on violence risk assessment and its practical application in review board hearings for NCRMD individuals.
  • Clinical practice in assessing risk for NCRMD individuals may not fully align with current best practices and validated instruments.