Prospective in-patient cohort study of moves between levels of therapeutic security: the DUNDRUM-1 triage security, DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales and the HCR-20

Davoren, Mary; O’Dwyer, Sarah T; Abidin, Zareena; Naughton, Leena; Gibbons, Olivia; Doyle, Elaine; McDonnell, Kim; Monks, Stephen; Kennedy, Harry G

doi:10.1186/1471-244x-12-80

Cited by 46 publications

(59 citation statements)

References 18 publications

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“…Davoren et al (2015) also found that a higher DUNDRUM-1 triage security score predicted a longer LOS. Lower (better) scores in the DUNDRUM-3 program completion and DUNDRUM-4 recovery scores predicted moves to less secure settings (Davoren et al, 2012) and conditional discharge to the community (Davoren et al, 2013) as did the HCR-20 dynamic scales. Another Dutch study found that patients in LFPC are more often recidivists than patients in RFPC ( Van der Kraan, Schekman, Nijman, Hulsbos, & Bulten, 2008) which aligns with the present findings.…”

Section: Discussionmentioning

confidence: 92%

“…Validation studies have shown good psychometric qualities (Flynn, O'Neill, McInerney, & Kennedy, 2011;Freestone et al, 2015;O'Dwyer et al, 2011) and indicated that the DUNDRUM-1 items can predict the level of therapeutic security needed (Flynn et al, 2011;Freestone et al, 2015) and LOS (Davoren et al, 2015) while the DUNDRUM-3 and DUNDRUM-4 can predict moves between levels of therapeutic security (Davoren et al, 2012) and discharge (Davoren et al, 2013).…”

Section: Dangerousness Understanding Recovery and Urgency Manual (Thmentioning

confidence: 99%

“…However, more recent studies showed that many inpatients in UK medium and high secure hospital (34 and 66%) have a mean LOS substantially exceeding 2 years (Shah et al, 2011). Studies in other European countries report mean LOS of 5.8 years in Sweden and Germany (Andreasson et al, 2014;Ross et al, 2012), 6.7 years in Croatia (Margetić et al, 2014) and an increasing LOS from 6.1 years (O'Neill et al, 2003) to 7.6 years in Ireland (Davoren et al, 2012). Also in the Netherlands, the average LOS of a forensic inpatient in high security provision rose from 5.6 to 9.8 years between 1990 and 2009 (Nagtegaal, Horst, & Schönberger, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, more attention has been drawn to length of stay (LOS) in forensic psychiatric care (Sharma, Dunn, O'Toole, & Kennedy, 2015). In several Western countries, the average duration a patient stays in highly secure forensic settings has been rising (Andreasson et al, 2014;Davoren et al, 2012;Margetić, Margetić, & Ivanec, 2014;O'Neill et al, 2003;Ross, Querengässer, Fontao, & Hoffmann, 2012;Shah, Waldron, Boast, Coid, & Ullrich, 2011;Sharma et al, 2015). Two decades ago researchers in the UK reported mean LOS in medium security was less than 2 years (Maden, Friendship, McClintock, & Rutter, 1999;McKenna, 1996).…”

Section: Introductionmentioning

confidence: 99%

“…Many studies have investigated patient characteristics affecting LOS in forensic psychiatry in several European countries and in the US (Andreasson et al, 2014;Davoren et al, 2012Davoren et al, , 2015Lammers, Nijman, & Vrinten, 2014;Margetić et al, 2014;Moran et al, 1999;O'Neill et al, 2003;Ross et al, 2012;Shah et al, 2011). Some of the factors found to be related to LOS were only found in some of the studies.…”

Section: Introductionmentioning

confidence: 99%

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Patient characteristics related to length of stay in Dutch forensic psychiatric care

Eckert¹,

Schel²,

Kennedy

et al. 2017

The Journal of Forensic Psychiatry & Psychology

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Create an overview of characteristics of patients in long-term forensic psychiatric care (LFPC) with a higher length of stay (LOS) care compared to patients in regular forensic psychiatric care (RFPC) with a shorter LOS. Data were collected from 139 patient records. This study examined whether patients in LFPC differ from patients in RFPC on sociodemographic data, legal data and clinical data and whether those characteristics are able to predict LOS. Patients in LFPC were more often born in a Dutch Caribbean country, less often had a substance abuse disorder, were more often emotionally neglected during childhood, had a higher HCR-20 risk item score, a higher security needs score, a higher (less successful) recovery score, were more often recidivist and had absconded more often than RFPC patients. Certain characteristics were able to distinguish the longer LOS group which might be useful to establish sequel services and enhance treatment efficiency.

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Section: Discussionmentioning

confidence: 92%

Section: Dangerousness Understanding Recovery and Urgency Manual (Thmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Patient characteristics related to length of stay in Dutch forensic psychiatric care

Eckert¹,

Schel²,

Kennedy

et al. 2017

The Journal of Forensic Psychiatry & Psychology

View full text Add to dashboard Cite

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Dynamic and Static Factors Associated with Discharge Dispositions: The National Trajectory Project of Individuals Found Not Criminally Responsible on Account of Mental Disorder (NCRMD) in Canada

Crocker

Nicholls

Charette

et al. 2014

Behavioral Sci & The Law

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The majority of individuals found not criminally responsible on account of mental disorder (NCRMD) in Canada spend some time in hospital before they are conditionally or absolutely (no conditions) discharged to the community by a legally mandated review board. By law, the decision to conditionally discharge an individual found NCRMD should be guided by the need to protect the public, the mental condition of the accused, and the other needs of the accused, especially regarding his/her community reintegration. At the time of this study, Canadian legislation and case law required that the review board disposition should be the "least onerous and least restrictive" possible for the accused. This means that, if there is no evidence that the person poses a significant risk to public safety, he/she must be released. However, the Canadian Criminal Code does not specify the criteria that must be considered when making this risk assessment. This leads to two questions. (1) What predicts review board dispositions? (2) To what extent do disposition determinations reflect evidence-based practices? The present study examined dynamic and static predictors of detention in custody, conditional discharge (CD), and absolute discharge (AD) dispositions among persons found NCRMD across the three largest provinces in Canada. The National Trajectory Project (NTP) examined men and women found NCRMD in British Columbia (BC), Québec (QC), and Ontario (ON) between May 2000 and April 2005, followed until December 2008. For the purposes of this study, individuals who had at least one hearing with a review board were extracted from the NTP dataset (N = 1794: QC = 1089, ON = 483, BC = 222). Over the course of the study, 6743 review board hearings were examined (QC = 3505, ON = 2185, BC = 1053). Despite advances in the risk assessment field, presentation of a comprehensive structured risk assessment to the review board was not the norm. Yet our findings suggest that review boards were taking into account a combination of empirically validated static and dynamic risk factors, as represented by the items of the HCR-20 risk assessment scheme. Particular attention was being paid to the behavior of the patient between hearings (e.g., violent acts, compliance with conditions). Severity of index offense was associated with review board decisions; though index severity is not related to recidivism, it is an important consideration in terms of public perceptions of the justice system and can be related to better established risk factors (i.e., criminal history and prior violence). Historical factors had more influence on the decision to detain someone, while clinical factors were more influential on an AD decision. Disposition stability was the most common trajectory, meaning that a patient with a prior CD disposition was most likely to receive another CD disposition at the next hearing. Static and dynamic risk factors found in the HCR-20 influenced review board determinations, although presentation of a complete structured risk assessment is the except...

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Quality of Life in Long-Term Clinical Forensic Psychiatry

Vorstenbosch

Escuder-Romeva

2019

Long-Term Forensic Psychiatric Care

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Prospective in-patient cohort study of moves between levels of therapeutic security: the DUNDRUM-1 triage security, DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales and the HCR-20

Cited by 46 publications

References 18 publications

Patient characteristics related to length of stay in Dutch forensic psychiatric care

Patient characteristics related to length of stay in Dutch forensic psychiatric care

Dynamic and Static Factors Associated with Discharge Dispositions: The National Trajectory Project of Individuals Found Not Criminally Responsible on Account of Mental Disorder (NCRMD) in Canada

Quality of Life in Long-Term Clinical Forensic Psychiatry

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