The utility of the Historical Clinical Risk -20 Scale as a predictor of outcomes in decisions to transfer patients from high to lower levels of security-A UK perspective 英文参考文献.docVIP

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The utility of the Historical Clinical Risk -20 Scale as a predictor of outcomes in decisions to transfer patients from high to lower levels of security-A UK perspective 英文参考文献.doc

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The utility of the Historical Clinical Risk -20 Scale as a predictor of outcomes in decisions to transfer patients from high to lower levels of security-A UK perspective 英文参考文献

DolanandBlattnerBMCPsychiatry2010,10:76 /1471-244X/10/76 RESEARCH ARTICLE OpenAccess TheutilityoftheHistoricalClinicalRisk-20Scale asapredictorofoutcomesindecisionsto transferpatientsfromhightolowerlevelsof security-AUKperspective MaireadDolan1*,RegineBlattner2 Abstract Background:StructuredProfessionalJudgment(SPJ)approachestoviolenceriskassessmentareincreasinglybeing adoptedintoclinicalpracticeininternationalforensicsettings.Theaimofthisstudywastoexaminethepredictive validityoftheHistoricalClinicalRisk-20(HCR-20)violenceriskassessmentscaleforoutcomefollowingtransfers fromhightomediumsecurityinaUnitedKingdomsetting. Methods:Thesamplewaspredominatelymaleandmentallyillandthemajorityofcasesweredetainedunderthe criminalsectionoftheMentalHealthAct(1986).TheHCR-20wasratedbasedondetailedcasefileinformationon 72casestransferredfromhightomediumsecurity.Outcomeswereexamined,independentofriskscore,andcases wereclassedas“successorfailure”basedonestablishedcriteria. Results:Themeanlengthoffollowupwas6years.ThetotalHCR-20scorewasarobustpredictoroffailureat lowerlevelsofsecurityandreturntohighsecurity.TheClinicalandRiskmanagementitemscontributedmostto predictiveaccuracy. Conclusions:AlthoughtheHCR-20wasdesignedasaviolenceriskpredictiontoolourfindingssuggestithas potentialutilityindecisionstotransferpatientsfromhightolowerlevelsofsecurity. Background been notable developments in systematizing the risk Over the last 3 decades there have been significant assessmentfieldwhichhaveledtotheintroductionofa developments in the field of violence risk assessment number of risk assessment tools that provide a more andmanagement.Itisincreasinglyrecognizedthatindi- structuredapproachtodecisionmaking[6,8,9].Thelat- viduals with mental disorder have an increased (4 to 6 ter Structured Professional Judgment (SPJ) approach times higher) risk of committing a violent crime [1,2]. providesguidelinesforassessingriskusingsystematized, Since the work of Monahan [3] unstructured clinical empir