Dr Phil Minoudis, who is a Consultant Clinical Psychologist at ELFT and the Joint Chair of the London Pathways Partnership (LPP), led the project. The LPP is a collaboration between ELFT, Oxleas, South London and Maudsley, Central and North West London and North London NHS Foundation Trusts, delivering the Offending Personality Disorder pathway in London.
A report was commissioned by the LPP to improve the sensitivity of detecting change over time on the HCR20 - a structured, professional judgement tool to assess the risk of future violence of individuals in a healthcare setting. Currently, it can be difficult for service users to demonstrate that they have changed, and it can be equally challenging to evaluate change at a service level.
The report included a study of four medium-secure units and four prison sites in England. Colleagues tested a novel response format for the HCR20 to find out if the tool performed as well as the existing version.
225 service users were evaluated across prison and forensic mental health settings. The project team compared the performance of the two rating scales for the HCR20 in terms of validity and reliability.
The results were positive. Findings showed that ratings using the novel response format had equal or better results in terms of reliable assessment of violence potential.
Commenting on the publication of the report, Dr Phil Minoudis said: “I would like to acknowledge the support we received from colleagues across prison and NHS sites, with particular gratitude to staff at the John Howard Centre, who produced the largest contribution to this study.
“With the help of our academic partners at Simon Fraser University, Canada, and Queen Mary University of London, and the persistence of several of the Forensic Personality Disorder Service team, we have made a significant contribution to the field of risk assessment.
“We hope to take this work further to develop more efficient approaches to evaluate violence potential, by reducing the burden on staff whilst maintaining the HCR20's high standards of reliability.”
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