Psychiatric Bulletin (2009) 33: 129-132. doi: 10.1192/pb.bp.108.019810
© 2009 The Royal College of Psychiatrists
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Use and perceived utility of structured violence risk assessments in English medium secure forensic units

Reena Khiroya, Medical Student

Faculty of Medicine, Imperial College London, 7 Longdean Park, Hemel Hempstead, Hertfordshire, HP3 8BS, email: reena.khiroya03{at}imperial.ac.uk

Tim Weaver, Senior Lecturer in Mental Health Services Research

Imperial College London

Tony Maden, Professor of Forensic Psychiatry

Imperial College London, and Clinical Director DSPD Service, West London Mental Health NHS Trust, Broadmoor Hospital, Berkshire

Declaration of interest

None.

AIMS AND METHOD

We surveyed the usage and perceived utility of standardised risk measures in 29 forensic medium secure units (a 62% response rate).

RESULTS

The most common instruments were Historical Clinical Risk–20 (HCR–20) and Psychopathy Checklist – revised (PCL–R); both were rated highly for utility. The Risk Matrix 2000 (RM2000), Sex Offender Risk Appraisal Guide (SORAG) and Static-99 were the most common sex offender assessments, but the Sexual Violence Risks–20 (SVR–20) was rated more positively for its use of dynamic factors and relevance to treatment.

CLINICAL IMPLICATIONS

Most medium secure units use structured risk assessments and staff view them positively. As HCR–20 and PCL–R/PCL–SV (Psychopathy Checklist – Screening Version) are so widely used they should be the first choices considered by other services.