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Police play an essential role in reducing harms associated with family violence by identifying people at increased risk of physical or mental health-related harm and linking them with support services. Yet police are often poorly trained and resourced to conduct the kind of assessments necessary to identify family violence cases presenting with increased risk. The paper aims to discuss this issue.

This paper describes a multi-project collaboration between law enforcement, forensic mental health, and academia that has over three years worked to improve risk assessment and management of family violence by police in Victoria, Australia.

Evaluation of existing risk assessment instruments used by the state-wide police force showed they were ineffective in predicting future police reports of family violence (AUC=0.54-0.56). However, the addition of forensic psychology expertise to specialist family violence teams increased the number of risk management strategies implemented by police, and suggested that the Brief Spousal Assault Form for the Evaluation of Risk assessment instrument may be appropriate for use by Australian police (AUC=0.63).

The practical implications of this study are as follows: police risk assessment procedures should be subject to independent evaluation to determine whether they are performing as intended; multidisciplinary collaboration within police units can improve police practice; drawing on expertise from agencies external to police offers a way to improve evidence-based policing, and structured professional judgement risk assessment can be used in policing contexts with appropriate training and support.

The paper describes an innovative collaboration between police, mental health, and academia that is leading to improved police practices in responding to family violence. It includes data from the first evaluation of an Australian risk assessment instrument for family violence, and describes methods of improving police systems for responding to family violence.

The purpose of this paper is to explore the violence risk assessment practices in Israel by social workers, clinical criminologists, and marriage and family therapists using a Web-based survey.

A Web-based survey and participation letter were translated into Hebrew and distributed to members of the Israel Association of Social Workers, the Israel Society of Clinical Criminology and the Israel Association for Marital and Family Therapy following the Dillman Total Design Survey Method.

The sample was composed of 34 professionals, who reported using structured instruments to predict and manage the likelihood of violence in over half of their risk assessments over both their lifetime and the past 12 months. Younger female respondents who entered their profession more recently were more likely to use instruments during the risk assessment process. There appeared to be a trend toward decreased use of actuarial instruments and increased use in structured professional judgment instruments.

The first national survey of violence risk assessment practices by behavioral healthcare professionals in Israel was conducted. This study revealed the risk assessment utility trends in Israel, finding that compared to professionals in North America, South America, Europe, East Asia and Australia, professionals in Israel conducted fewer risk assessments and used structured instruments less often, highlighting concern about the lack of reliance on evidence-based techniques in the country.

The purpose of this paper is to outline the process of risk assessment for terrorists and violent political extremists and to present an example of such an approach. The approach proposed is referred to as the VERA 2 or violent extremism risk assessment protocol (Consultative Version 2).

A review of the knowledge base relating to risk assessment and risk assessment methodology was undertaken with a focus on relevance to individual terrorists and violent extremists. The need for a specific approach for the risk assessment of terrorists that differs from approaches used for ordinary violent criminals was identified. A model that could be used for the risk assessment of terrorists was identified with pertinent risk indicators. This was structured into a protocol referred to as the VERA (Consultative Version 2). The approach is intended to be applied to different types of violent extremists, terrorists and unlawful violent offenders motivated by religious, political or social ideologies.

First, risk assessments of adjudicated terrorists and violent extremists should be undertaken with risk indicators that are relevant to ideological motivated violence. Indicators used for ordinary common violence differ in substantive ways from those relevant to terrorists and therefore may have questionable relevance for the assessment of risk in terrorists. Second, it is possible to construct an evidence‐based risk assessment approach for the range of violent extremists and terrorists using a structured professional judgment approach with pertinent risk indicators. The VERA 2 is an example of this type of risk assessment protocol for terrorists and unlawful violent extremists.

Risk assessment tools that have been developed for ordinary violent criminals and members of organised criminal gangs should be used with caution with terrorists, violent extremists and other perpetrators of ideologically motivated unlawful violence. Specific risk assessment approaches for terrorists with relevant indicators should be used. At this time, terrorist oriented approaches such as the VERA 2 are to be considered consultative and used as an add‐on to other established approaches.

There are few transparent, structured risk assessment approaches that use indicators specifically relevant to violent political extremists and terrorists. One new approach, the VERA 2 is outlined in the paper using risk indicators that differ in substantive ways from those used for other ordinary violent criminals.

The purpose of this paper is to examine empirical, epistemological and conceptual challenges and clinical narratives in the application of risk assessment and management in mental health.

The authors used a narrative review of empirical, conceptual and clinical literature.

The worldwide prevalence of violence in mental health settings remains high. Risk assessment and management approaches, while well intentioned as an attempt to reduce harm and increase people’s safety, have negligible effect on both. They are invariably individual centric, ignore wider environmental, societal and behavioural influences that foment violence and have a stigmatising effect on people using mental health services. They also reinforce the myth that people who are mentally unwell threaten society and that through current risk assessment and management approaches, we can minimise this threat.

There is a need to reconsider the study and application of violence risk assessment in mental health.

The practice of risk assessment and management in mental health is marred by an overuse of risk assessment measures that are limited in their predictive efficacy. As a result, they have little value in preventing, reducing and/or managing harm. The language of risk punishes and stigmatises service users and reinforces the image of menace. An alternative language of safety may nourish and protect. A collaborative approach to safety assessment based upon recovery-focussed principles and practices may fuse professionals and service users’ horizons. Combining service users’ self-perception, professionals’ sound clinical judgement, assisted by electronically derived risk algorithms and followed by evidence-based risk management interventions, may lessen the threat to service users, reduce harm and transform the practice of violence risk assessment and management.

Risk appraisals discriminate against the small number of people who have a mental illness and are risky, an example of preventive detention that is ethically questionable. On the basis of the limitations of the predictive efficacy of actuarial measures, it is ethically dubious to subject people to interventions with limited benefits. Risk assessment processes tend to reinforce stigma by classifying individuals as risky, sanctioning society’s prejudices and fear through scientific authority.

The increasing focus on risk assessment and management to tackle violence in mental health is fraught with empirical, conceptual and practical concerns; the authors have suggested ways in which these concerns can be addressed without compromising people’s safety.

The purpose of this study was to explore the predictive validity of the revised Problem Identification Checklist (PIC‐R) in predicting inpatient and community violence using a retrospective design. The Historical Scale (H‐Scale) of the HCR‐20 was employed to control for static risk factors. The predictive accuracy between predictors and outcome measures was evaluated using Receiver Operating Characteristics (ROC) analysis. The PIC‐R significantly predicted inpatient violence (AUC range 0.77‐0.92) over a 12‐month follow‐up period but did not predict community violence. Conversely, the H‐Scale significantly predicted community violence (AUC 0.82) but did not predict inpatient violence over a 12‐month follow‐up period. The findings offer preliminary validation for the predictive accuracy of the PIC‐R for violence in a UK inpatient population. Additionally, the findings suggest that short‐term risk of violence within a psychiatric inpatient population may be more related to dynamic and clinical risk variables rather than to static ones.

The purpose of this paper is to explore how raters combine constituent components of Historical Clinical Risk-20 (HCR-20) risk assessment, and how relevant they rate the tool to different diagnostic and demographic groups.

A cross-sectional survey design of n=45 mental health clinicians (psychiatrists, psychologists, and others) working in a secure hospital responded to an online survey about their risk assessment practice.

HCR-20 Historical and Clinical subscales were rated the most relevant to violence prediction but four of the five items rated most relevant were Historical items. A recent history of violence was rated more important for risk formulation than Historical and Risk management items, but not more important than Clinical items. While almost all respondents believed predictive accuracy would differ by gender, the tool was rated similarly in terms of its relevance for their client group by people working with men and women, respectively.

This was an exploratory survey and results should be verified using larger samples.

Clinicians judge recent violence and Clinical items most important in inpatient violence risk assessment but may overvalue historical factors. They believe that recent violent behaviour is important in risk formulation; however, while recent violence is an important predictor of future violence, the role it should play in SPJ schemes is poorly codified.

It is important that risk assessment is accurate in order to both protect the public and to protect patients from overly lengthy and restrictive detention.

Despite the vast number of studies examining the predictive validity of tools like HCR-20 very little research has examined the actual processes and decision-making behind formulation in clinical practice.

This article describes an initiative undertaken by a clinical team in a medium secure unit to manage their workload by offering training in structured violence risk assessment to local mental health professionals. The HCR‐20 violence risk assessment tool was used in this context. A number of half‐day training sessions were offered to a multidisciplinary audience in three local areas in the West Midlands covered by the team. This initiative was evaluated by feedback from participants, which suggested that the training was well‐received and considered broadly useful.

The purpose of this study is to provide mental health practitioners with a framework for conceptualizing individuals who may be at risk of targeted violence, mass shootings in particular.

Through the lens of the Path to Intended Violence model, a non-experimental descriptive design was chosen to explore the characteristics and behaviors of perpetrators who had engaged in mental health treatment within six months before their attacks.

The perpetrators in this study demonstrated behaviors included in each of the stages of the Path to Intended Violence model. Thus, it may be important for practitioners to be familiar with this model, especially the earlier stages, to potentially identify and intervene with individuals who may be at risk of committing mass violence.

This paper highlights how the Path to Intended Violence model can provide practitioners with a framework for identifying progressive warning signs in patients and how to take action to stop them from continuing their journey toward violence.

Risk assessment is a fundamental aspect of forensic practice. This paper reviews some of the logical issues inherent in the process of assessing risk. A structured generic model for conducting such assessments is outlined and explicated. This is followed by coverage of some of the major recent research findings, with a particular focus on the assessment of risk of violence towards others in forensic mental health contexts. In conclusion some of the major points for practice and future research are discussed.

Integral to the process of formulating and managing the difficulties of mentally disordered offenders is the assessment of risk. However, the opinion held by many clinicians who work with offenders with an autism spectrum disorder (ASD) is that most conventional risk assessment tools fail to capture the underlying reasons why such individuals may offend. This needs to be explored.

The paper presents a screening study of the HCR 20 risk assessment tool and some other characteristics of ‘high risk’ individuals with an ASD. Also presented is a brief literature review supported by clinical experience of the assessment of psychopathy in ASD and highlighting potential key factors to be included in a risk assessment of offenders with an ASD.

It was found that nine out of the 20 risk items contained in the HCR 20 are present in 50 per cent or less of the sample. Whilst some conventional risk factors are present, clinical experience and the literature suggests that it is the specific difficulties associated with having an ASD that contribute towards an individual's vulnerability to offend.

Although further examination is required, provisional findings from this small screening study of the HCR 20 profiles of high risk individuals with an ASD questions the usefulness of some conventional risk factors in understanding the difficulties within this population. It is proposed that there is a need for good practise guidelines for assessing risk in individuals with an ASD.