Risk management in forensic psychiatry

Risk assessment plays an important role in forensic psychiatric treatment to determine the likelihood of violent behaviour during and/or after treatment. Risk assessments are usually conducted to support major clinical forensic decisions such as those regarding leave. Risk assessment instruments like the HKT-R (Spreen, Brand, Ter Horst, & Bogaerts, 2014) and HCR-20^V3 (De Vogel, De Vries Robbe, Bouman, Chakhssi, & de Ruiter, 2013; Douglas, Hart, Webster, & Belfrage, 2013) provide indicators to support structured professional judgement when evaluating risk factors. Risk factors are categorised as static or dynamic (Douglas, Webster, Hart, Eaves, & Ogloff, 2001). Static factors (age at first offence, prior criminal history, etc.) are useful for evaluating long-term risk, but largely unchangeable and untreatable. Dynamic risk factors (coping, self-control, etc.) are treatable and changeable over time and therefore feasible as treatment goals for interventions to minimise, monitor and control risk.