Forensic Mental Health Practitioners’ Use of Structured Risk Assessment Instruments, Views about Bias in Risk Evaluations, and Strategies to Counteract It

Kamorowski, Jennifer; Ruiter, Corine de; Schreuder, Maartje; Ask, Karl; Jelícic, Marko

doi:10.1080/14999013.2021.1895377

Cited by 8 publications

(6 citation statements)

References 113 publications

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“…Although the LS/CMI was originally developed for correctional settings, it has since been shown to measure general criminality among forensic psychiatric populations (Olver & Kingston, 2019). Other forensic tools have also been applied to appraise different types of offending behavior in forensic psychiatric settings (Kamorowski et al, 2022), such as the Psychopathy Checklist–Revised (Hare, 2003), Static-99 (Hanson & Thornton, 1999), Structured Assessment of Violence Risk in Youth (Borum et al, 2002), Sexual Violence Risk–20 (Boer et al, 1997), Spousal Assault Risk Assessment Guide (Kropp et al, 1994), and Guidelines for Stalking Assessment and Management (Kropp et al, 2011). Although the profusion of risk instruments provides forensic clinicians with many options to appraise risk, not all tools are suitable for all forensic settings or populations.…”

Section: Legislative Backgroundmentioning

confidence: 99%

Static and dynamic predictors of forensic mental health decision-making.

Cheng¹,

Olver²,

Haag³

et al. 2023

Psychological Services

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In Canada, individuals found not criminally responsible on account of mental disorder (NCR) fall under the supervision of a jurisdictional review board (RB) per the Criminal Code. Limited research has examined whether RB decisions balance the needs of public safety with social reintegration as intended by federal legislation. To fill this gap, the present study determined whether forensic decisional outcomes in one provincial RB system accounted for information relevant to violence risk. Study instruments included the Level of Service/Case Management Inventory (LS/CMI), Historical Clinical Risk Management-20 Version 3, and the Revised Violence Risk Appraisal Guide. A retrospective longitudinal design was employed to examine an NCR cohort (N = 109) that entered the RB system between 2005 and 2010 and their respective RB hearings (N = 327) until 2015. Results indicated that risk-relevant information was supplied to the RB by forensic professionals; however, key criminogenic risk and need factors as defined by the LS/CMI were absent in clinical reports. RB decisions were still strongly predicted by empirically supported risk factors linked to violent recidivism. Higher release likelihoods corresponded to a proportionally greater reliance on dynamic risk factors to enact dispositions. Forensic risk instruments are central aspects of correctional rehabilitation, and the results demonstrated their relevance to forensic tribunals. It is recommended that information from a forensic risk instrument be routinely delivered to RBs to support evidence-based decision-making. Impact StatementReview boards are required by the Canadian Criminal Code to balance public safety needs with the social rehabilitation of supervised forensic patients. Despite being supplied with an incomplete profile of risk and need information by forensic professionals, decision-making outcomes were still predicted by risk factors linked to violent reoffending. Forensic risk instruments provide information relevant to violence risk and can assist with evidence-based decision-making in forensic psychiatric settings.

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Section: Legislative Backgroundmentioning

confidence: 99%

Static and dynamic predictors of forensic mental health decision-making.

Cheng¹,

Olver²,

Haag³

et al. 2023

Psychological Services

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“…In this review, we include several projects that found evidence of the bias blind spot among forensic mental health experts as well (Neal & Brodsky, 2016; Zapf et al, 2018; Zappala et al, 2018; cf. Kamorowski et al, 2021).…”

Section: What Is Cognitive Bias?mentioning

confidence: 99%

“…We include these adversarial allegiance studies in the current systematic review. We also include other studies measuring forensic mental health experts’ understandings of bias and debiasing strategies (Commons et al, 2004; Kamorowski et al, 2021; MacLean et al, 2019; Neal & Brodsky, 2016) and a couple of studies examining forensic reports for evidence of potential bias (Iudici et al, 2015; Neal, 2018a).…”

Section: What Is Cognitive Bias?mentioning

confidence: 99%

A general model of cognitive bias in human judgment and systematic review specific to forensic mental health.

Neal¹,

Lienert²,

Denne³

et al. 2022

Law and Human Behavior

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Objective. Cognitive biases can impact experts' judgments and decisions. We offer a broad descriptive model of how bias affects human judgment. Although studies have explored the role of cognitive biases and debiasing techniques in forensic mental health, we conducted the first systematic review to identify, evaluate, and summarize the findings. Hypotheses. Given the exploratory nature of this review, we did not test formal hypotheses. General research questions included the proportion of studies focusing on cognitive biases and/or debiasing, the research methods applied, the cognitive biases and debiasing strategies empirically studied in the forensic context, their effects on forensic mental health decisions, and effect sizes. Method. A systematic search of PsycINFO and Google Scholar resulted in 22 records comprising 23 studies in the United States, Canada, Finland, Italy, the Netherlands, and the United Kingdom. We extracted data on participants, context, methods, and results. Results. Most studies focused only on cognitive biases (k = 16, 69.6%), with fewer investigating ways to address them (k = 7, 30.4%). Of the 17 studies that tested for biases, 10 found significant effects (58.8%), four found partial effects (23.5%), and three found no effects (17.6%). Foci included general perceptions of biases; adversarial allegiance; bias blind spot; hindsight and confirmation biases; moral disengagement; primacy and recency effects; interview suggestibility; and cross-cultural, racial, and gender biases. Of the seven debiasing-related studies, nearly all (k = 6) focused at least in part on the general perception of debiasing strategies, with three testing for specific effects (i.e., cognitive bias training, consider-the-opposite, and introspection caution), two of which yielded significant effects. Conclusions. Considerable clinical and methodological heterogeneity limited quantitative comparability. Future research could build on the existing literature to develop or adapt effective debiasing strategies in collaboration with practitioners to improve the quality of forensic mental health decisions. Public Significance StatementEvidence of bias in forensic mental health emerged in ways consistent with what we know about human judgment broadly. We know less about how to debias judgments-an important frontier for future research. Better understanding how bias works and developing effective debiasing strategies tailored to the forensic mental health context hold promise for improving quality. Until then, we can use what we know now to limit bias in our work.

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“…Instead, it is common practice to base risk assessments on a screening of the history of psychological disorders and mental health, and to use clinical judgment to estimate the general functioning of mental mechanisms such as perception, cognition, memory, motivation, emotion, and will. In the light of the advantages of empirically validated measures (Kamorowski et al, 2022), various forensic procedures would benefit from access to translated and validated assessment instruments to improve PCS management, treatment, and rehabilitation in the Romanian prison system.…”

mentioning

confidence: 99%

Predictive Validity of the Static-99R in Romania

Toma

Kube

Hurezan³

et al. 2022

Criminal Justice and Behavior

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Empirical actuarial measures are significantly more accurate than unstructured clinical judgments in predicting recidivism risk of incarcerated populations across different cultures. In a retrospective study, we examined the predictive validity of the Static-99R, the actuarial measure most used around the world for assessing the recidivism risk of persons who committed a sexual offense (PCS), in a sample of 518 male PCS in Romania. The results showed a good predictive validity for any kind of recidivism (area under the curve [AUC] = .70) and a slightly lower predictive accuracy for violent (AUC = .69) and sexual recidivism (AUC = .67). Effect sizes and the predictive validity of the single items of the Static-99R have also been examined. In addition, the predicted rates of reconviction have been compared with the observed rates. The Romanian version of the Static-99R has been shown as a valid, useful tool to predict sexual, violent, and general recidivism for Romanian PCS.

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Forensic Mental Health Practitioners’ Use of Structured Risk Assessment Instruments, Views about Bias in Risk Evaluations, and Strategies to Counteract It

Cited by 8 publications

References 113 publications

Static and dynamic predictors of forensic mental health decision-making.

Static and dynamic predictors of forensic mental health decision-making.

A general model of cognitive bias in human judgment and systematic review specific to forensic mental health.

Predictive Validity of the Static-99R in Romania

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