Rethinking Risk Assessment The MacArthur Study of Mental Disorder and Violence

by Monahan, John; Steadman, Henry J.; Silver, Eric; Appelbaum, Paul S.; Clark Robbins, Pamela; Mulvey, Edward P.; Roth, Loren H.; Grisso, Thomas; Banks, Steven

• ISBN13: 9780195138825
• ISBN10: 0195138821
• Format: Hardcover
• Copyright: 2001-03-01
• Publisher: Oxford University Press

Summary

The presumed link between mental disorder and violence has been the driving force behind mental health law and policy for centuries. Legislatures, courts, and the public have come to expect that mental health professionals will protect them from violent acts by persons with mental disorders. Yet for three decades research has shown that clinicians' unaided assessments of "dangerousness" are barely better than chance.Rethinking Risk Assessment: The MacArthur Study of Mental Disorder and Violencetells the story of a pioneering investigation that challenges preconceptions about the frequency and nature of violence among persons with mental disorders, and suggests an innovative approach to predicting its occurrence. The authors of this massive project -- the largest ever undertaken on the topic -- demonstrate how clinicians can use a "decision tree" to identify groups of patients at very low and very high risk for violence. This dramatic new finding, and its implications for the every day clinical practice of risk assessment and risk management, is thoroughly described in this remarkable and long-anticipated volume. Taken to heart, its message will change the way clinicians, judges, and others who must deal with persons who are mentally ill and may be violent will do their work.

Table of Contents

Violence Risk Assessment: The Law and the Science	3	(12)
Violence Among Patients in the Community	15	(22)
Testing ``Criminological'' Risk Factors	37	(24)
Testing ``Clinical'' Risk Factors	61	(30)
Customizing Risk Assessment	91	(24)
Combining Customized Risk Assessments to Produce the Best Estimate of Risk	115	(14)
Violence and the Clinician: Assessing and Managing Risk	129	(16)
Appendix A	145	(18)
Appendix B	163	(6)
References	169	(18)
Index	187