Risk Assessment

 • Risk Assessment • TERMINOLOGY • CRITERION OF RISK: • DEFINITION OF THE RISK BEING ASSESSED, eg Risk of Assault on Staff, Risk of Self-Injury, Risk of Sexual Recidivism, and so on. • TERMINOLOGY • RISK FACTORS (OR PREDICTORS): THE ENVIRONMENTAL OR PERSON-SPECIFIC FACTORS THAT PREDICT THE LIKELIHOOD OF THE CRITERION OF RISK ACTUALLY HAPPENING, eg For Violence: History of Violence Verbal Aggression, Uncontrolled Anger • SPECIAL HOSPITALS • Three Special Hospitals in England, one in Scotland: • Ashworth in Liverpool • Broadmoor in Crowthorne • Rampton in Notts • Carstairs in Lanarkshire • SPECIAL HOSPITALS • To treat in conditions of maximum security those people who pose a serious risk to the community; many of whom will have committed grave offences but are detained under Mental Health (rather than criminal justice) legislation. PRISONS • Decisions about level of security, from High Security to Open Prisons • Parole decisions about risk to the community HITS AND MISSES IN PREDICTION •   • •   •   •   • Actual Yes • •   • Actual No • •   • Predict Yes • •   • True Positive • (A Hit) • •   • False Positive • (A Miss) •   •   • Predict No • •   • False Negative • (A Miss) • •   • True Negative • (A Hit) •   PREDICTION IN THE REAL WORLD • Two Decisions Points where Prediction is Important: • 1. To Admit a Person into Security or to Remain in the Community • 2. To Release from High Security into Medium Security or to the Community •   • •   • A QUESTION OF RISK • Critical Question: • Is this person a risk to the public? • Answer: • What does your prediction of risk say? PREDICTION IN THE REAL WORLD • PREDICT YES: ACTUAL YES • Will (rightly) be admitted to Security • or • Will (rightly) stay in Security •   • Good Decision! • PREDICTION IN THE REAL WORLD • PREDICT YES: ACTUAL NO • Will (wrongly) be admitted to Security • or • Will (wrongly) stay in Security •   • Bad Decision! • PREDICTION IN THE REAL WORLD • PREDICT NO: ACTUAL YES • No Admission but Further Offending • or • Released (wrongly) from Security •   • Either Way, Looks Like a Public Inquiry! • PREDICTION IN THE REAL WORLD • PREDICT NO: ACTUAL NO • No Admission : No Further Offending • or • Released (rightly) from Security •   • Either Way, Happy Ever After! CONDUCTING A RISK ASSESSMENT • CLINICAL PREDICTION • Individual Practitioner • Clinical Team • Case Conference • CONDUCTING A RISK ASSESSMENT • ACTUARIAL (OR STATISTICAL) PREDICTION • Uses Actuarial Statistical Methods to Identify Risk Factors for a Given Criterion of Risk ACTUARIAL PREDICTION • Accurate Measurement of Criterion of Risk (eg Violent Conduct) • Accurate Measurement of Potential Predictors (eg Criminal History, Psychiatric Diagnosis) STATIC AND DYNAMIC PREDICTORS • Static (Cannot Change) Predictors • Criminal History • Demographic Information • Dynamic (Clinical) Predictors • Situational and Social Factors • Psychological and Psychiatric Factors •   ACTUARIAL SCALES • CALIFORNIA BASE EXPECTANCY SCALE • SALIENT FACTOR SCALE • WISCONSIN JUVENILE PROBATION AND AFTERCARE INSTRUMENT • RECIDIVISM PREDICTION SCORE • SALIENT FACTOR SCALE • ITEM A. PRIOR CONVICTIONS/ADJUDICATIONS • [None=3; One=2; Two or three=1; Four or more=0] • ITEM B. PRIOR COMMITMENT(S) OF MORE THAN 30 DAYS • ITEM C. AGE AT CURRENT OFFENSE/PRIOR COMMITMENTS • ITEM D. RECENT COMMITMENT FREE PERIOD (THREE YEARS) • ITEM E. PROBATION/PAROLE/CONFINEMENT/ESCAPE STATUS VIOLATOR THIS TIME • ITEM F. HISTORY OF HEROIN/OPIATE DEPENDENCE TYPICAL ACTUARIAL SCALES • Violence Risk Appraisal Guide (VRAG) • Psychopathy Checklist- Revised (PCL-R) • Level of Service Inventory-Revised (LSI-R) • Historical-Clinical-Risk Assess. (HCR-20) • OASys • VRAG (Harris et al., 1993) • Separation from parents under age 16 • Victim injury in index offence (-ve) • DSM-III schizophrenia (-ve) • Never married • Elementary school maladjustment • PCL-R score • • Female victim-index offence (-ve) • Failure on prior conditional release • Property index offence history • Age at index offence • Alcohol abuse history • DSM-III personality disorder • PCL-R • Pathological lying • Manipulative • Lack of remorse or guilt • No emotional depth • Callous • Parasitic lifestyle • LSI-R • Criminal History • Education/ • Employment • Finance • Family/Marital • Accommodation • • Leisure/Recreation • Companions • Alcohol/Drug Problems • Emotional Problems • Attitudes • Sample HCR-20 Items • Historical Clinical Risk •   •   • Age at First Offence Insight Support •   • Alcohol/Drug Abuse Attitude Comply •   • Early Maladjustment Symptoms Stress • OASys • Assess how likely it is that an offender will be reconvicted • Identify offending-related needs • Assess risk of harm • Inform practice OASys • Risk of Reconviction and Offending Related Factors • Risk of Serious Harm • Planning for Supervision • OASys • Risk of Harm to Others • Risk of Harm to Children • Risk of Harm to Self • Security Risks OASys: Risk of Reconviction ◦ Offending Information ◦ Accommodation ◦ Education and Employability ◦ Financial Management ◦ Relationships ◦ OASys: Risk of Reconviction • Lifestyle and Associates • Drug Misuse • Alcohol Misuse • Emotional Wellbeing • Thinking and Behaviour • Attitudes OASys: Risk of Harm to Others • Type of Offence (Violent/Stalking) • Assaults on Staff • Assaults on Other Prisoners • OASys: Risk of Harm to Self • Suicide • Self-Harm • Coping • Vulnerability OASys: Further Assessment Required • Sex Offender • Violent Offender • Basic Skills • Drugs • Alcohol • Mental Health/PD • Domestic Violence OASys: Scoring • Scores for each area of risk are weighted and a score from 0-162 is calculated • The Total Score gives the Risk of reconviction within 2 years of the assessment OASys: Scoring Risk of Reconviction • High : 100 and Above • Medium : 41-99 • Low :

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