The predictive validity of the HCR-20 following clinical implementation: does it work in practice?

This prospective study describes the predictive validity of the Historical Clinical Risk Management-20 Scale (HCR-20) when applied to clinical practice among 109 male mentally disordered offenders in a high secure forensic hospital. Data on violent incidents including reconvictions were collected from multiple sources. The results imply that the implemented HCR-20s did not predict future violence regardless of setting (community vs inpatient) nor time (short vs long term) except for serious incidents. This may indicate that the implemented HCR-20s informed risk management through systematic tailoring of care and treatment plans. Evidence supporting this interpretation was found in a reduction in violent incidents and offending when compared to an earlier study with a similar cohort. Alternatively, the completion of a violence risk assessment by clinicians rather than researchers may have affected the quality of completed assessments. Further research is required to better understand the complex mechanisms...