Risk assessment with intellectual disabled forensic psychiatric patients: how useful are risk assessment instruments?
background Instruments for assessing the risk of violent behaviour have proved their worth in the field of forensic psychiatry. However, it is not certain whether such instruments provide an accurate assessment of recidivism when used with psychiatric patients who have an intellectual disability.
aim To find out whether these instruments – or which of these instruments – can provide a reliable assessment of the risk of violent sexual recidivism if used with forensic psychiatric patients who have an intellectual disability. method We searched PubMed, Psycinfo and Google Scholar for studies in English or Dutch, published between 1980 and 2010, concerning the reliability of instruments for assessing the risk of recidivism in forensic psychiatric patients with an intellectual disability.
results The studies show that several of the risk assessment instruments currently in use provide reliable predictions concerning patients with an intellectual disability.
conclusions The hcr-20 and hkt-30 are recommended for assessing the risk of violent recidivism in patients with an intellectual disability. The Static-99 is the preferred instrument for assessing the risk of sexual recidivism. Further research is needed for assessing to what extent svr-20, armidilo, dros and pcl-r are applicable to forensic psychiatric patients in the Netherlands who have an intellectual disability.