Violence Risk Assessment Practices in Denmark: A Multidisciplinary National Survey

Abstract

Abstract:With a quadrupling of forensic psychiatric patients in Denmark over the past 20 years, focus on violence risk assessment practices across the country has increased. However, information is lacking regarding Danish risk assessment practice across professional disciplines and clinical settings; little is known about how violence risk assessments are conducted, which instruments are used for what purposes, and how mental health professionals rate their utility and costs. As part of a global survey exploring the application of violence risk assessment across 44 countries, the current study investigated Danish practice across several professional disciplines and settings in which forensic and high-risk mental health patients are assessed and treated. In total, 125 mental health professionals across the country completed the survey. The five instruments that respondents reported most commonly using for risk assessment, risk management planning and risk monitoring were Brøset, HCR-20, the START, the PCL-R, and the PCL:SV. Whereas the HCR-20 was rated highest in usefulness for risk assessment, the START was rated most useful for risk management and risk monitoring. No significant differences in utility were observed across professional groups. Unstructured clinical judgments were reported to be faster but more expensive to conduct than using a risk assessment instrument. Implications for clinical practice are discussed.

Unidimensionality of the Strengths and Vulnerabilities Scales in the Short-Term Assessment of Risk and Treatability (START)

“…This emphasis on the importance of individual strengths alongside vulnerabilities has contributed to a widespread acceptance that an overall risk estimate is more valid if it takes positive, protective factors into account (Robb e et al, 2013). These two features, alongside the comprehensiveness of the domains covered by the twenty items, has led to the popularity of the START in a large number of services (Nielsen et al 2015;Singh et al, 2016).…”

Staff Perceptions of Facilitators and Barriers to the Use of a Short- Term Risk Assessment Instrument in Forensic Psychiatry

“…Even using SRAIs, risk assessments might be erroneous, but an explicit and structured procedure allows such assessments to be fully analyzed and, if needed, revised (Allnut et al, 2010). However, experience-based nonstructured clinical assessment of risk remains a common practice within forensic mental health care (Nielsen et al, 2015;Singh, Serper, Reinharth, & Fazel, 2011).…”