Risk assessment and management in Forensic mental health Essay

Risk assessment and management in Forensic mental health - Essay Example Each of these has its own merit and used together, they can render a judgment that is more accurate than using only one method. Risk for a mental health patient generally means an assessment of whether the individual will become violent against themselves or against others. In one respect, a clinician can only make judgments about an individual based on what they have observed or what the assessment tool tells them. Unfortunately, the individual may be able to get through evaluations and still have an episode of violence. This is one of the reasons why Carroll (2007) suggests that more formalized instruments for assessing risk should be used instead of relying on programs that are developed locally. The reason this is important is because locally devised programs are often lacking in validity and reliability. Carroll points out however, that using more than one source for assessing risk is very important. Professional Judgement Laureau suggests that although structured professional j udgment is used by many people, there are times when the decision must include other assessment instruments, especially when an individual has a secondary problem. In this case, the individual was Bipolar and it was found that although the professional judgement of the psychiatrist was that the individual was able to go out into the community, the fact remained that he had killed two people during a manic phase. In this situation, when the individual went to trial, it was determined (through emotional evidence by the prosecutors) that the individual should not be released, even though he was gong to be released into a community program. This information seems to indicate that if there had been more than one assessment, which looked at several issues for this particular individual, there may have been a different ruling. Unstructured professional often comes under scrutiny because it is based on a clinician's intuition and therapeutic experience with the incarcerated individual. It u ses psychiatric evaluation, clinical notes and the personal experience of the person evaluating the individual. This type of assessment is still used today, although it may be the least reliable (Gowensmith, n.d.). Structured professional judgement has a combination of static and dynamic information, is flexible, and allows different scenarios to be developed. Bottom line on this is to answer the question of whether the individual is going to be safe to be released, and it has a 70% change of being correct (Gowensmith, n.d.). In addition, Bouch and Marshall (2005) suggest that structured professional judgement is useful because it supports evidence-based practice and it also is useful in "increasing the transparency of decision making for the purposes of clinical governance" (p. 85). This suggests that professional judgement is very useful, but in conjunction with other types of risk assessment. Assessment Tools There are many assessment tools that some clinicians use in order to cr eate an understanding of risk management. The PCL-R (Psychopathy Checklist: Screening Version-Revised) is a 20 item assessment that according to Buchanan (2009) score items like alcohol abuse, separation from parents before the age of 16 and whether the individual failed on other release attempts. This seems to be a rather harsh instrument that may or may not allow for an individual to improve over time. This instrument also