The increasing influence of risk assessment on forensic patient review board decisions

N. Zoe Hilton, Alexander I. Simpson, Elke Ham
2016 Psychological services  
Always cite the published version, so the author(s) will receive recognition through services that track citation counts, e.g. Scopus. If you need to cite the page number of the author manuscript from TSpace because you cannot access the published version, then cite the TSpace version in addition to the published version using the permanent URI (handle) found on the record page. Abstract Previous studies of mental health tribunal decisions about forensic patients indicate some changes over time
more » ... e changes over time in the use of empirically supported risk factors. Our aim was to investigate whether, in more recent cases, risk assessment instruments were cited by the tribunals or the clinicians making recommendations to them, and whether there was evidence of an association between risk assessment results and either clinical recommendations or tribunal dispositions. Among review board hearings held in 2009-2012 pertaining to 63 different maximum security patients found not criminally responsible on account of mental disorder in Ontario, Canada, dispositions were most strongly associated with psychiatrists' testimony, consistent with previous studies. Dispositions were, however, associated with the scores on the Violence Risk Appraisal Guide (VRAG), such that transferred patients had a lower risk of violent recidivism than detained patients. An association between clinical opinions and risk assessment results was also found to be significant, and significantly larger than in previous research. There was no evidence that risk assessment was cited selectively in higher risk cases or when scores were concordant with the tribunal decision. This research may provide a baseline for studies of the effect of 2014 legislations introducing a high-risk designation for forensic patients in Canada. We recommend further efforts to measure the effect of non-pharmacological treatment participation and in-hospital security decisions on tribunal decision-making.
doi:10.1037/ser0000068 pmid:27504642 fatcat:pdf35cyfzvfafiolruei5v4zx4