Could we have done more? Risk assessment and violence – Healthy Debate [2023-10-10]

Every week, we read of a violent act that could have or should have – or we like to think that it could have or should have – been prevented. The perpetrator is usually a repeat offender. He (for usually it is a male) has been granted bail, granted parole, given a day pass or moved to a less secure facility, discharged to a half-way house or simply to the community, from either a correctional system facility or a forensic psychiatry facility.

In most cases, a review or parole board has sanctioned the change to a less secure environment with less supervision. Many of these decisions, in part, have been based on a “risk assessment” by mental health professionals (forensic psychiatrists or psychologists), and by an assessment of the behaviour of the individual while in custody or treatment. This latter often includes comments on “admitting guilt and taking responsibility,” “showing remorse,” “engaging in pro-social activity” and “attending therapy or counselling.”

Currently, some objective tools (evidence-based psychopathy checklists) are used in a risk assessment but some subjective judgements are based on self-reporting, interviews and testimony. Ultimately though, a risk assessment will arrive at very broad conclusions such as “low risk to re-offend,” “moderate risk” and “high risk.”

In any decision to discharge, release or reduce security, legal, humanitarian and civil liberty considerations must play a role.

But there is a different and far more objective question that could be asked of the mental health professionals: “Apart from incarceration, with this individual, do we have the tools to reduce to zero or minimal risk the possibility of re-offending?” And this question can be objectively answered based almost solely on the original crime(s) or “index offences,” the context of those crimes and the presence or absence of a treatable condition.

Healthy Debate
October 10, 2023