Implementation of Evidence-Based Practices in Forensic Mental Health Services

Risk Assessment With the START:AV in Dutch Secure Youth Care

“…The majority of determinants reported in the present study are recognized in the literature as important conditions for successful implementation. In accordance with prior work on risk assessment implementation (Levin et al, 2016;Müller-Isberner et al, 2017;Nonstad & Webster, 2011;Schlager, 2009;Sher & Gralton, 2014;Webster et al, 2006), our findings highlight the importance of involvement and commitment on all levels, dedicated leadership, inclusive and transparent communication, adequate resource allocation, training, timing, monitoring, and integration in existing structures.…”

“…Lastly, the reader should take into consideration that the present study reflects perceptions of staff members from a particular service with a particular client population, during a particular (political) time. Yet, parallels with previous studies (Levin et al, 2016;Müller-Isberner et al, 2017;Nonstad & Webster, 2011;Schlager, 2009;Sher & Gralton, 2014;Webster et al, 2006) suggest that our results might be transferable to other contexts, at least to residential treatment settings. To enhance applicability of risk assessment implementation studies, we advocate for the use of implementation frameworks, such as the CFIR to allow comparison between settings and instruments.…”

“…Yet, the quality of implementation is crucial for the effectiveness of risk assessment instruments in reducing recidivism. Müller-Isberner et al (2017) stated that "positive outcomes are achieved only when both the implementation process and the practice are effective" (p. 465). Other researchers have expressed concerns that even psychometrically sound instruments will fail to improve outcomes for clients if not implemented properly (Desmarais, 2017;Schlager, 2009).…”

“…A final limitation is that we did not survey all relevant stakeholders, for example, perceptions of management and youths were not examined. Their attitudes can facilitate or hinder the implementation process and are important to include in future evaluations (Levin et al, 2015;Müller-Isberner et al, 2017). During the present implementation, the managing director, who was a strong advocate for structured risk assessment, left the service, resulting in more fragile support for risk assessment at the managerial level.…”

Implementing the START:AV in a Dutch residential youth facility: Outcomes of success.

“…A final limitation is that we did not survey all relevant stakeholders, for example, perceptions of management and youths were not examined. Their attitudes can facilitate or hinder the implementation process and are important to include in future evaluations (Levin et al, 2015; Müller-Isberner, Born, Eucker, & Eusterschulte, 2017). During the present implementation, the managing director, who was a strong advocate for structured risk assessment, left the service, resulting in more fragile support for risk assessment at the managerial level.…”