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Troquete, Nadine; Brink, Rob H. S. van den; Beintema, Harry; Mulder, Tamara; Os, T.W.D.P. van; Schoevers, Robert A.; Wiersma, Doede

doi:10.1192/bjp.202.6.468a

Cited by 3 publications

(3 citation statements)

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“…Despite the many advances within this research field, there are still challenges remaining to understand the clinical use and usefulness of structured risk assessments in forensic psychiatry. The need for more research has been raised in relation to • Barriers and facilitators to the implementation of SRAIs in clinical settings (Haque, 2016;Vojt, 2013;Desmarais, 2017;Borum, 2003;Webster, 2011); • How best to formulate and communicate risk assessments to inform risk management (Hart et al, 2016;Scurich, 2016); • How and to what extent the SPJ risk assessment and risk management plan actually influence clinical care and risk management in clinical settings by informing and guiding the planning of such interventions (Troquete et al, 2013a(Troquete et al, , 2013bWand and Large, 2013;Fazel and Björkly, 2016;Daffern, 2007;Storey et al, 2015;Singh et al, 2014aSingh et al, , 2014bSturup et al, 2013;Vojt et al, 2013); • What specific treatment and risk management interventions are effective in reducing different types of violent behaviour and other adverse events (Wolf et al, 2017;Maguire et al, 2017;de Vogel et al, 2012); • Clear definitions of risk management interventions (Maguire et al, 2017); • Definitions and the predictive validity of protective factors (Arbisi, 2016); and • Patient participation in risk assessments and their perceptions of mediating factors for violence (Dickens, 2015;Lockertsen et al, 2018;Buch Gudde et al, 2015;Eidhammer et al, 2014). Figure 1 provides a simplistic summary overview of the main steps and actions described in the intended use of SRAIs in forensic psychiatric settings and the gaps in research evidence.…”

Section: Discussionmentioning

confidence: 99%

“…Without commonly agreed upon definitions and coding schemes for care and risk management interventions, as well as outcome measures, evaluating the clinical relevance of the findings in study 3 might be difficult. How and to what extent the structured risk assessments influence care and risk management is however an imperative aspect to investigate (Fazel and Björkly, 2016;Elbogen, 2016;Storey et al, 2015;Singh et al, 2014aSingh et al, , 2014bSturup et al, 2013;Vojt et al, 2013;Troquete et al, 2013aTroquete et al, , 2013bWand and Large, 2013;Daffern, 2007;). The findings support the assumed and intended clinical use of SPJIs to influence the provision of care and risk management interventions.…”

Section: Clinical Use Of Structured Risk Assessment Instruments By Fimentioning

confidence: 99%

“…The research evidence on that SPJ risk assessments actually influence treatment and risk management in clinical settings is scarce and with that, the actual clinical usefulness of the assessment (Elbogen, 2016;Troquete et al, 2013aTroquete et al, , 2013bWand and Large, 2013). The need for further research on the intended and assumed correlation between risk assessment and risk management, by adherence to risk management plans (i.e.…”

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confidence: 99%

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The challenges of using structured risk assessment instruments in forensic psychiatric care

Levin

2019

Linköping University Medical Dissertations

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Background: The purpose of psychiatric forensic care is to provide treatment for mentally ill offenders and to prevent future acts of violence and other adverse events. During care, the type of restrictions of freedom, the patient's continuous need for involuntary treatment and readiness for discharge, are continuously evaluated based on the assessment of risk the patient pose to themselves and others as well as the progress achieved with treatment. The use of structured risk assessment instruments is recommended in clinical guidelines to assess such risks. However, unstructured clinical assessments, considered to be less valid, are often used in clinical practice. There is insufficient research evidence concerning several aspects related to the clinical use of structured risk assessment instruments in terms of guiding the planning and realization of care and risk management interventions. There is also a lack of knowledge about what patients themselves perceive to be mediating factors for their use of violence. The challenges of using structured risk assessment instruments 8 al care givers. Patients are often actively striving and struggling to understand and manage their own risk of acting out in violence. Real-life experiences in forensic psychiatric care sparked my interest in trying to understand more about the barriers and facilitators of the clinical use of structured risk assessments to prevent violence and other adverse events as well as the patient perspectives on factors that contribute to or inhibit violence. This PhD thesis is the product of this endeavour. NICE, 2007; Risk Management Authority, 2006). SRAIs have been developed for and implemented and used in forensic mental health services, secure psychiatric in-care services and correctional services to assess the risk of adverse events. Much of the research of risk assessment instruments comes from these different types of services.

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