Are release recommendations for NGRI acquittees informed by relevant data?

Manguno-Mire, Gina M.; Thompson, John W.; Bertman-Pate, Lisa Jo; Burnett, Darla R.; Thompson, Hilary W.

doi:10.1002/bsl.724

Cited by 30 publications

(24 citation statements)

References 20 publications

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“…The present results support increased training for forensic clinicians on empirically valid violence risk factors, and there is some evidence that forensic decisions can be improved (Manguno-Mire, Thompson, Bertman-Pate, Burnett, & Thompson, 2007). Perhaps a database of systematic reviews of forensic research is needed (i.e.…”

Section: General Discussion and Conclusionsupporting

confidence: 51%

Improving forensic tribunal decisions: the role of the clinician

McKee

Harris

Rice

2007

Behavioral Sci & The Law

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Three empirical investigations of forensic decision-making were conducted: a study of 104 hearings by a forensic tribunal; an evaluation of which aspects of forensic patients' clinical presentation were empirical predictors of violence; and a survey of forensic clinicians to determine which factors they said they used to assess risk of violent recidivism and which they actually used. Results showed a significant correlation between actuarial risk and clinical advice to the tribunal, and a nonsignificant trend for patients higher in actuarial risk to receive more restrictive dispositions. Psychotic diagnoses and symptoms were not indicators of increased risk of violent recidivism. Clinicians endorsed some empirically valid indicators of risk, but also relied on some invalid indicators. There was also inconsistency between factors clinicians said they used and factors actually related to their hypothetical decision-making. An automated system is presented as an illustration of how the consistency and validity of forensic decisions could be enhanced.

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Section: General Discussion and Conclusionsupporting

confidence: 51%

Improving forensic tribunal decisions: the role of the clinician

McKee

Harris

Rice

2007

Behavioral Sci & The Law

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“…Univariate analysis of a general linear model was carried out for discharge, co-varying for the HCR-20 total score at the beginning of the period of observation because the HCR-20 measure of dynamic risk is already established as a predictor of success or failure in such discharges [5-8]. Similarly, we tested whether the HCR-20 scores differentiated between those discharged and those not when co-varying for DUNDRUM-3 and DUNDRUM-4 scores.…”

Section: Methodsmentioning

confidence: 99%

“…Doyle at al have also shown that dynamic (“current” and “risk”) items on the HCR-20 significantly improved the accuracy of prediction of violence after discharge from forensic units [7]. It has been shown that factors such as a higher score on PCL-R and a younger age at the time of first criminal offence were significantly related to release recommendations in a group of NGRI patients in the USA [8]. However evidence presented to Criminal Law (Mental Health) Review boards, when recommending a patient for a move to less secure places, consists of more than risk assessment.…”

Section: Introductionmentioning

confidence: 99%

Prospective study of factors influencing conditional discharge from a forensic hospital: the DUNDRUM-3 programme completion and DUNDRUM-4 recovery structured professional judgement instruments and risk

et al. 2013

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BackgroundWe set out to examine whether structured professional judgement instruments DUNDRUM-3 programme completion (D-3) and DUNDRUM-4 recovery (D-4) scales along with measures of risk, mental state and global function could distinguish between those forensic patients detained in a secure forensic hospital (not guilty by reason of insanity or unfit to stand trial) who were subsequently discharged by a mental health review board. We also examined the interaction between these measures and risk, need for therapeutic security and eventual conditional discharge.MethodsA naturalistic observational cohort study was carried out for 56 patients newly eligible for conditional discharge. Patients were rated using the D-3, D-4 and other scales including HCR-20, S-RAMM, START, SAPROF, PANSS and GAF and then observed over a period of twenty three months during which they were considered for conditional discharge by an independent Mental Health Review Board.ResultsThe D-3 distinguished which patients were subsequently discharged by the Mental Health Review board (AUC = 0.902, p < 0.001) as did the D-4 (AUC = 0.848, p < 0.001). Item to outcome analysis showed each item of the D-3 and D-4 scales performed significantly better than random. The HCR-20 also distinguished those later discharged (AUC = 0.838, p < 0.001) as did the S-RAMM, START, SAPROF, PANSS and GAF. The D-3 and D-4 scores remained significantly lower (better) for those discharged even when corrected for the HCR-20 total score. Item to outcome analyses and logistic regression analysis showed that the strongest antecedents of discharge were the GAF and the DUNDRUM-3 programme completion scores.ConclusionsStructured professional judgement instruments should improve the quality, consistency and transparency of clinical recommendations and decision making at mental health review boards. Further research is required to determine whether the DUNDRUM-3 programme completion and DUNDRUM-4 recovery instruments predict those who are or are not recalled or re-offend after conditional discharge.

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“…For example, in a study of individuals found NGRI at the Forensic Division of the Eastern Louisiana Mental Health System, over half were diagnosed with schizophrenia, 36% were diagnosed with a substance use disorder, and 28% with a personality disorder. NGRI accused were predominantly male, had a mean age of 41, were unmarried, and the majority had a criminal history, of which 69% involved violent offenses (Manguno-Mire, Thompson, Bertman-Pate, Burnett, & Thompson, 2007). In a follow-up of all forensic patients discharged from the Auckland Regional Forensic Psychiatry Service in New Zealand from 1998 to 2004, the majority were single men with a mean age of 38 years.…”

Section: Forensic Populationsmentioning

confidence: 97%

International Trends in Demand for Forensic Mental Health Services

Jansman-Hart

Seto

Crocker

et al. 2011

International Journal of Forensic Mental Health

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Deinstitutionalization, changes in both criminal and civil law, and the use of the criminal justice system to manage problematic behavior by individuals with serious mental illnesses have affected the number of people entering forensic mental health systems. This review examines data revealing trends in demand for forensic services in Canada, the United States, and internationally. The number of beds and resources allocated to forensic mental health services has steadily increased not only in Canada, but in other countries across the world. In Canada, the number of new accused entering the system doubled annually from 1992 to 2004. In the United States, the number of individuals found not guilty by reason of insanity (NGRI), forensic beds and forensic expenditures have all increased dramatically in recent years. Furthermore, countries in

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Are release recommendations for NGRI acquittees informed by relevant data?

Cited by 30 publications

References 20 publications

Improving forensic tribunal decisions: the role of the clinician

Improving forensic tribunal decisions: the role of the clinician

Prospective study of factors influencing conditional discharge from a forensic hospital: the DUNDRUM-3 programme completion and DUNDRUM-4 recovery structured professional judgement instruments and risk

International Trends in Demand for Forensic Mental Health Services

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