The Assessment of Risk and Assessing Competency

Can violence be predicted?

• courts have allowed clinicians to make predictions, but acknowledged their fallibility

• risk assessment or dangerousness potential

  • wording matters

    • some researchers view risk as being highly dependent on situations and circumstances

Clinical Assessments

• rely on clinical experience and professional judgment

Actuarial Assessment

• measurable, valid risk factors

Drawbacks of Actuarial Assessments

• focused on a small number of factors

• passive predictors

  • focus on static variables

• may include risk factors that are not accepted on legal grounds

  • race, sex

• may ignore risk factors that have unknown validity

  • threats of violence

• may not generalize to other contexts

• have restricted definition of violence risk

  • cannot address nature, duration, severity/frequency, and how soon violence may occur

Structured Professional Judgment (SPJ)

• gathering critical info

• identifying presence of risk factors

• evaluating their relevance

• developing scenarios in which the individual may or may not be violent

Risk Factors

individual characteristics believed to be associated with or predictive of antisocial behavior

• Dynamic

• Static

Dynamic Risk Factors

change over time and situation

• Substance abuse

• Attitudes towards a specific group

• Can be divided into

  • Stable:

    • change occurs slowly

      • attitudes

  • Acute:

    • change occurs rapidly

      • mood swings

      • emotional arousal

    • better predictors of the tendency of sex offenders to reoffend

Static Risk Factors

cannot change; historical factors

• age of onset

• criminal history

• criminality in family

• diagnoses

Risk Assessment Instruments

• should only be conducted by psychologists or other MHPs

• be certain that the instruments used have empirical support in research literature

  • designed by:

    • gathering target population

    • identifying key variables

Competency to Stand Trial (CST)

• fitness to stand trial or fitness to proceed

• can occur in jail, psychiatric hospital, or community

  • can be reevaluated

Dusky v. United States

defendants are competent to stand trial if:

• they have “sufficient present ability to consult with [their] lawyer”

• defendants must understand what is happening AND be able to assist their attorney in the preparation of their defense

• “Dusky standard”

The Competency Screening Test (CST)

• sentence completion test

  • “when a jury hears my case, they will…”

  • intended to provide a quick assessment

    • but is wrong 53.3% of the time

The MacArthur Competency Assessment Tool - Criminal Adjudication (MacCAT-CA)

• vignette describing a situation in which a person is charged with a crime and are asked questions about it

Evaluation of Competency to Stand Trial - Revised (ECST-R)

• interview based

  • focuses on the “Dusky standard”

• ability to detect malingering

Other Measures of Competency

• Interdisciplinary Fitness Interview-Revised (IFI-R)

  • semi-structured interviews

Assessment of Malingering

• required in every type of forensic mental health assessment

• malingering in attempt to:

  • delay proceedings

  • get a case dismissed

  • avoid a trial

• Structured Interview of Reported Symptoms

Methods of Restoration to Competency

• administration of medication

• civil commitment

Mens Rea

• “guilty mind”

• people cannot be help responsible for crimes if they did not possess this

Competency

mental state at the time of the criminal justice proceedings

Sanity

mental state at the time of the crime

Insanity Standards

• use of tests to determine the extent of criminal responsibility

  • knowledge of the difference between right and wrong

  • awareness of what one is doing is wrong

• Insanity Defense Reform Act (IDRA)

  • sets the standard for insanity in cases in federal courts

• Guilty but mentally ill (GBMI(

Rogers Criminal Responsibility Assessment Scales (R-CRAS)

rated on:

• psychopathology

• reliability of their report of the crime

• organicity

• cognitive control

• behavioral control

Mental State at the Time of the Offense Screening Evaluation (MSE)

• an observation of the person’s appearance and assessment of orientation

  • psychomotor activity

  • behavior

  • attitude

  • emotional responses

Treatment of Defendants Found NGRI

• period of civil commitment

  • follow-up and monitoring services

• conditional release