Evaluation of a model of violence risk assessment (HCR-20) among adult patients discharged from a gazetted psychiatric hospital in Hong Kong

• Published in: The journal of forensic psychiatry & psychology 2013-08, Vol.24 (4), p.479-495
• Main Authors: Ho, Robyn Mei Yee, Lau, Jonathan Siu Fung, Cheung, Henry Hon Kee, Lai, Tony Tai Sum, Tam, Venus Fung Ling, Chan, Wai Lan, Yuen, Kwok Kuen, Yan, Chor Kwan
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Adults; Biological and medical sciences; Chinese people; Discharge; Discharged; Evaluation; Forensic psychiatry; HCR-20; Hong Kong; Interrater reliability; Judgment; Medical sciences; Mental hospitals; Miscellaneous; Patients; PFU system; Psychiatric hospitals; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reliability; Risk; Risk assessment; Violence; violence risk assessment
• ISSN: 1478-9949; 1478-9957
• DOI: 10.1080/14789949.2013.809467

Background: Structured professional judgement (SPJ) method has been considered as a useful approach to violent risk assessment. However, an unstructured clinical model of violence risk assessment, the Priority Follow-up (PFU) system is employed in Hong Kong. The Historical/Clinical/Risk Management - 20 (HCR-20) is the SPJ instrument that had been most researched but has not been previously validated in a Chinese population. Study design and methods: HCR-20 was completed for 110 discharged general adult or forensic psychiatric patients with a PFU status and also for the same number of demographically matched controls. Violence was determined from case notes at 6- and 12-month after the HCR-20 rating. Results: HCR-20 was rated with acceptable interrater reliability. The predictive validity of the structured final risk judgement was significant, yielding moderate to large effect sizes, for all of the violent outcomes at 6 and 12 months. When compared with the PFU system, the final risk judgement yields no significant differences.