Evaluation of a Proposed Revision of the HCR-20 Violence Risk Assessment Scheme.

Violence is a serious public health concern. It embodies a considerable societal burden and its individual cost, in terms of both physical and mental health, is enormous, whether it pertains to victims, perpetrators or those close to them. Currently, legal, forensic and psychiatric institutions are confronted with the difficult task of determining whether a specific individual may be at risk of harming others. Violence risk assessments are conducted in order to find a way to reduce or manage that risk, either in the community or within institutions. Because the decisions made by mental health professionals during such assessments have serious consequences, it is essential that the decision-making processes be scientifically and clinically sound. The Historical/Clinical/Risk-Management-20 (HCR-20) represents one of the most researched and established instruments used to assess risk for community and institutional violence in offenders, civil psychiatric patients, forensic psychiatric patients, as well as males and females with mental illness, personality disorder or substance abuse problems. Since the development of the HCR-20 in 1997, a large body of data on its efficacy has been collected, and the authors concluded that some revisions were necessary. Diana Strub's research involves an evaluation of a subscale of the revised HCR-20 assessment scheme in its entirety on a new sample of 150 individuals (i.e. offenders and mentally disordered offenders), about to be released into the community. Her work has implications for violence risk reduction and management for individuals with mental illness, personality disorders, correctional involvement and/or substance abuse problems. Such violence prevention strategies are expected, in turn, to considerably reduce physical and mental health concerns for those at risk, their victims and those close to them, as well as alleviate some of the burden placed on the health care system.