Factors Associated with Recommitment of NGRI Acquittees to a Forensic Hospital

Abstract

The current archival study assesses risk factors associated with recommitment of 142 individuals adjudicated Not Guilty by Reason of Insanity (NGRI) from civil settings to a forensic hospital in New York State. Within 10 years of transfer from a forensic hospital, 40 (28.2%) were recommitted. Using survival analyses to account for the wide range in opportunity for recommitment, period of transfer (i.e., pre versus post the 1995 case of George L, which clarified factors related to assessments of dangerousness) and the Historical scale and specific items of the HCR-20 emerged as important risk factors for recommitment. Specifically, hazard of recommitment was 2.9 times higher for those with high Historical scores as compared to those with low scores. However, few individual risk factors were associated with recommitment. Prior supervision failure, negative attitude, problems with substance use, and absent or less serious major mental illness and relationship problems were informative in predicting recommitment over 10 and 3 year follow-up periods.

A Comparison of the HCR-20V3 Among Male and Female Insanity Acquittees: A Retrospective File Study

“…Provided that this standard is met, patients may be hospitalized indefinitely. In a previous study, including a partially overlapping sample with the current study, patients admitted between 1980 and 2010 were hospitalized for an average of 45.0 months (Median D 33 months; SD D 46.4), although there was great variability (range D 1-249 months) (Green et al, 2014). A more recent estimate indicates that NGRI acquittees are retained in the forensic hospital for an average of nine years (personal communication, Deputy Director).…”

Reconviction and revocation rates in Flanders after medium security treatment

“…Literature demonstrates that revocations for rule violations are higher than revocations for acquisition of new criminal charges (Vitacco, Vauter, Erickson, & Ragatz, 2014;Wiederanders, 1992). Revocation rates of rule violations range from 5% to 49% (Bertman-Pate et al, 2004;Callahan & Silver, 1998;Green et al, 2014;Manguno-Mire, Coffman, DeLand, Thompson, & Myers, 2014;Vitacco et al, 2008;Vitacco et al, 2014;Wiederanders, Bromley, & Choate, 1997) over different follow-up periods ranging from 1.7 to 5.1 years.…”

An update and expansion on the role of the Violence Risk Appraisal Guide and Historical Clinical Risk Management‐20 in United States case law

“…For instance, it is unclear if the legal decision‐maker's concept of “lack of insight” coincides with the definition outlined in the HCR‐20 manual or the expert's own idiosyncratic conceptualization. Moreover, within a research context, compared with the other 20 items this item was ranked as the second most subjective (Rufino, Boccaccini, & Guy, ), with an interclass correlation coefficient (ICC) = 0.58 (Douglas, Ogloff, & Hart, ), although Green et al () reported a higher reliability estimate in a clinical setting, (ICC = 0.86). Thus, while still well within the “fair” (Rufino et al, ) to “excellent” range (Green et al, ), the potential subjectivity of this item emphasizes the need for experts to clearly define this construct and how it was rated as it relates to the current individual.…”