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Touristic activities risk assessment -Approach and results. SASTDes WP3.7 Report

Violence Risk Assessment in Women

Women and girls represent only a minority in the penitentiary system and in forensic mental health care. About 6%–10% of both prison and forensic psychiatric populations in Western countries comprise women (see for the most recent offi cial statistics in the UK w ww.gov. uk/government, in Canada w ww.statcan.gc.ca, and in the US w ww.bjs.gov) . However, there seems to be widespread agreement that in the past 20 years female offending has been on the rise, especially violent offending and particularly among young women ( Miller, Malone, and Dodge, 2010; M oretti, Catchpole, and Odgers, 2005) . Overall, a disproportionate growth of females entering the criminal justice system and forensic mental health care has been observed in many countries (for reviews, see Nicholls, Cruise, Greig, and Hinz, 2015; Odgers, Moretti, and Reppucci, 2005 ; Walmsley, 2015) . In addition, it should be noted that the ‘dark number’ for women is suggested to be bigger than for men. Offi cial prevalence rates of female offending might constitute an underestimation as women usually commit less reported offences, for example, domestic violence (N icholls, Greaves, Greig, and Moretti, 2015) . Furthermore, it has been found that – if apprehended – girls and women are treated more leniently by professionals and the criminal justice system. Generally, they receive lower prison sentences and are more often admitted to civil psychiatric institutions instead of receiving a prison sentence or mandatory forensic treatment after committing violence ( Javdani, Sadeh, and Verona, 2011 ; Jeffries, Fletcher, and Newbold, 2003 ). Hence, although female offenders compared to male offenders are a minority, female violence is a substantial problem that deserves more attention. Our understanding of female offenders is hindered by the general paucity of theoretical and empirical investigations of this population. In order to improve current treatment and assessment practices, our knowledge and understanding of female offenders should be enlarged and optimised (d e Vogel and Nicholls, 2016 ).

Staff Perceptions on the Implementation of Structured Risk Assessment with the START:AV: Identifying Barriers and Facilitators in a Residential Youth Care Setting

An effective implementation approach is crucial for successful integration of structured risk assessment instruments into practice. This qualitative study explored barriers and facilitators to the implementation of the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) in a Dutch residential youth care service. Perceptions of staff members from various disciplines were gathered through focus group interviews at three consecutive occasions. After inductive coding of the interview extracts using thematic analysis, the identified codes were linked to the consolidated framework for implementation research. Through this framework, factors that influence an implementation project can be organized into multiple domains and constructs. In the present study, staff members described implementation barriers related to characteristics of the risk assessment instrument, staff, and the implementation process. In addition, features of the setting were frequently mentioned as hindering the implementation, such as hierarchy, culture, communication, as well as implementation climate and readiness for change. Staff members also identified multiple facilitators, such as experienced advantages of the START:AV compared to the previous risk assessment practice and positive beliefs about the instrument. The article concludes with recommendations for successful implementation of structured risk assessment instruments in forensic-clinical practice.

Linking Theory and Practice in Probation. Structured Decision Support for Case Management Plans

In this thesis several studies are presented that have targeted decision making about case management plans in probation. In a case management plan probation officers describe the goals and interventions that should help offenders stop reoffending, and the specific measures necessary to reduce acute risks of recidivism and harm. Such a plan is embedded in a judicial framework, a sanction or advice about the sanction in which these interventions and measures should be executed. The topic of this thesis is the use of structured decision support, and the question is if this can improve decision making about case management plans in probation and subsequently improve the effectiveness of offender supervision. In this chapter we first sketch why structured decision making was introduced in the Dutch probation services. Next we describe the instrument for risk and needs assessment as well as the procedure to develop case management plans that are used by the Dutch probation services and that are investigated in this thesis. Then we describe the setting of the studies and the research questions, and we conclude with an overview of this thesis.

Adherence to Structured Risk Assessment Guidelines: Development and Preliminary Evaluation of an Adherence Scale for the START:AV

Risk assessment instruments are widely used to predict risk of adverse outcomes, such as violence or victimization, and to allocate resources for managing these risks among individuals involved in criminal justice and forensic mental health services. For risk assessment instruments to reach their full potential, they must be implemented with fidelity. A lack of information on administration fidelity hinders transparency about the implementation quality, as well as the interpretation of negative or inconclusive findings from predictive validity studies. The present study focuses on adherence, a dimension of fidelity. Adherence denotes the extent to which the risk assessment is completed according to the instrument’s guidelines. We developed an adherence measure, tailored to the ShortTerm Assessment of Risk and Treatability: Adolescent Version (START:AV), an evidence-based risk assessment instrument for adolescents. With the START:AV Adherence Rating Scale, we explored the degree to which 11 key features of the instrument were adhered to in 306 START:AVs forms, completed by 17 different evaluators in a Dutch residential youth care facility over a two-year period. Good to excellent interrater reliability was found for all adherence items. We identified differences in adherence scores on the various START:AV features, as well as significant improvement in adherence for those who attended a START:AV refresher workshop. Outcomes of risk assessment instruments potentially impact decision-making, for example, whether a youth’s secure placement should be extended. Therefore, we recommend fidelity monitoring to ensure the risk assessment practice was delivered as intended.

Gender-sensitive Violence Risk Assessment

Most violence risk assessment tools have been validated predominantly in males. In this multicenter study, the Historical, Clinical, Risk Management–20 (HCR-20), Historical, Clinical, Risk Management–20 Version 3 (HCR-20V3), Female Additional Manual (FAM), Short-Term Assessment of Risk and Treatability (START), Structured Assessment of Protective Factors for violence risk (SAPROF), and Psychopathy Checklist–Revised (PCL-R) were coded on file information of 78 female forensic psychiatric patients discharged between 1993 and 2012 with a mean follow-up period of 11.8 years from one of four Dutch forensic psychiatric hospitals. Notable was the high rate of mortality (17.9%) and readmission to psychiatric settings (11.5%) after discharge. Official reconviction data could be retrieved from the Ministry of Justice and Security for 71 women. Twenty-four women (33.8%) were reconvicted after discharge, including 13 for violent offenses (18.3%). Overall, predictive validity was moderate for all types of recidivism, but low for violence. The START Vulnerability scores, HCR-20V3, and FAM showed the highest predictive accuracy for all recidivism. With respect to violent recidivism, only the START Vulnerability scores and the Clinical scale of the HCR-20V3 demonstrated significant predictive accuracy.