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The precarious practice of forensic psychiatric risk assessments

Nilsson, Thomas; Munthe, Christian; Gustavson, Christina LU ; Forsman, Anders and Anckarsäter, Henrik LU (2009) In International Journal of Law and Psychiatry 32(6). p.400-407
Abstract
The development of forensic psychiatric risk assessments is discussed from a clinical point of view using the example of Sweden. A central task in forensic psychiatry has traditionally been to identify dangerous, mentally disordered subjects considered to be prone to commit violent acts. Over time, "dangerousness" has been reworded into "risk". Nevertheless, such assessments have generally been based on the psychiatric factors characterising the individual patient, while group interaction, situational factors, or social and cultural circumstances, such as the availability of alcohol and drugs, have been largely overlooked. That risk assessments have a focused on people with a diagnosis of "mental disorder" and been used as grounds for... (More)
The development of forensic psychiatric risk assessments is discussed from a clinical point of view using the example of Sweden. A central task in forensic psychiatry has traditionally been to identify dangerous, mentally disordered subjects considered to be prone to commit violent acts. Over time, "dangerousness" has been reworded into "risk". Nevertheless, such assessments have generally been based on the psychiatric factors characterising the individual patient, while group interaction, situational factors, or social and cultural circumstances, such as the availability of alcohol and drugs, have been largely overlooked. That risk assessments have a focused on people with a diagnosis of "mental disorder" and been used as grounds for coercive measures and integrity violations has somehow been accepted as a matter of course in the public and political debate. Even the basic question whether offenders with a mental disorder are really more prone to criminal recidivism than other offenders seems to have been treated light-handedly and dealt with merely by epidemiological comparisons between groups of persons with broad ranges of psychosocial vulnerability and the general population. Legal texts, instructions and guidelines from the authorities in charge are often vague and general, while actors in the judicial system seem to put their trust in psychiatric opinions. The exchange of professional opinions, general public expectations, and judicial decision processes poses a huge risk for misunderstandings based on divergent expectations and uses of terminology. (C) 2009 Elsevier Ltd. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Mentally disordered offenders, Risk assessment, Forensic psychiatry, Ethical dilemmas, Violence
in
International Journal of Law and Psychiatry
volume
32
issue
6
pages
400 - 407
publisher
Elsevier
external identifiers
  • wos:000272812200010
  • scopus:70350770959
ISSN
0160-2527
DOI
10.1016/j.ijlp.2009.09.010
language
English
LU publication?
yes
id
25db9529-2d92-4ba7-b645-1ab0b156d217 (old id 1532325)
date added to LUP
2010-01-29 11:14:55
date last changed
2017-03-26 03:35:17
@article{25db9529-2d92-4ba7-b645-1ab0b156d217,
  abstract     = {The development of forensic psychiatric risk assessments is discussed from a clinical point of view using the example of Sweden. A central task in forensic psychiatry has traditionally been to identify dangerous, mentally disordered subjects considered to be prone to commit violent acts. Over time, "dangerousness" has been reworded into "risk". Nevertheless, such assessments have generally been based on the psychiatric factors characterising the individual patient, while group interaction, situational factors, or social and cultural circumstances, such as the availability of alcohol and drugs, have been largely overlooked. That risk assessments have a focused on people with a diagnosis of "mental disorder" and been used as grounds for coercive measures and integrity violations has somehow been accepted as a matter of course in the public and political debate. Even the basic question whether offenders with a mental disorder are really more prone to criminal recidivism than other offenders seems to have been treated light-handedly and dealt with merely by epidemiological comparisons between groups of persons with broad ranges of psychosocial vulnerability and the general population. Legal texts, instructions and guidelines from the authorities in charge are often vague and general, while actors in the judicial system seem to put their trust in psychiatric opinions. The exchange of professional opinions, general public expectations, and judicial decision processes poses a huge risk for misunderstandings based on divergent expectations and uses of terminology. (C) 2009 Elsevier Ltd. All rights reserved.},
  author       = {Nilsson, Thomas and Munthe, Christian and Gustavson, Christina and Forsman, Anders and Anckarsäter, Henrik},
  issn         = {0160-2527},
  keyword      = {Mentally disordered offenders,Risk assessment,Forensic psychiatry,Ethical dilemmas,Violence},
  language     = {eng},
  number       = {6},
  pages        = {400--407},
  publisher    = {Elsevier},
  series       = {International Journal of Law and Psychiatry},
  title        = {The precarious practice of forensic psychiatric risk assessments},
  url          = {http://dx.doi.org/10.1016/j.ijlp.2009.09.010},
  volume       = {32},
  year         = {2009},
}