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Tijdschrift voor Psychiatrie 43 (2001) 3, 151 - 161

Essay

From danger to risk: Managing instead of warning

H.J.C. van Marle

Assessing risk before leave and termination of forensic treatment is very important because of the big consequences for society and the patient himself. The usual clinical examination by a psychiatrist or a psychologist depends very much on the setting, the experience and the expertise of the examiner. The introduction of a more objective standard for decision making is recommended for the whole process of reporting to the courts and other decision makers. Experiences with risk assessment scales, like those developed in Canada, are hopeful but validation is needed for the Dutch situation. This more objective assessment though is not able to replace the examination for the degree of criminal responsibility as only the hermeneutic method gives insight in the specific combination of offender and offence. Also during the forensic psychiatric treatment individual examination remains essential for the planning of the therapeutic process. The expectation is that the combination of the individual and the assessment approach will make the treatment more specific and more effective concerning the risks. The implementation of the risk assessment/risk management cycle within the forensic field brings many advantages by following and evaluating the forensic patients intensively. It is well known that some of them can be a danger for society for many years after a completed treament.

keywords forensic psychiatric report, hermeneutics, risk assessment, risk management