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When evaluating a person’s risk and protective factors, it is not always possible to complete a comprehensive risk assessment. If so, risk screening is often more feasible. This support tool offers an initial evaluation of the most important risk and protective factors to determine a person’s level of concern for violence and criminal behaviour.
During his presentation at the International Forensic Psychiatry Lecture Series, Dr. Michiel de Vries Robbé shared positive evaluations from professionals and clients who used a risk screening. He also showed the optimistic predictive findings in prison and youth settings.
Risk Screening
The Dutch prison system and programs for troubled youth have limited trained staff, time, and funding. In-depth risk assessments are reserved for people with severe psychiatric disorders.
Dr. de Vries Robbé’s team developed feasible tools for risk screening, so staff can quickly evaluate a person’s risk and protective factors and determine the level of concern.
The risk screening is completed soon after the person enters the prison or youth program. The screening identifies risk factors to minimize and protective factors to strengthen to reduce the level of concern. When the screening reveals moderate or serious concerns, staff can request that a mental health professional complete a full risk assessment and tailor risk management interventions.
Risk and protective factors are graded as not or hardly, moderately, or clearly present, or unknown. Dr. de Vries Robbé emphasized that the ratings matter less than the reasoning behind them. The process highlights which risk and protective factors are most important. Final conclusions are judged as few to no concerns, moderate concerns, or serious concerns for violent behaviour, criminal behaviour (youth), or both.
Risk Screener Violence
A prison administrative staff member completes Part 1 of the Risk Screener Violence (RS-V) when a person enters the facility. They review the person’s files for previous violence toward other people inside prison (if previously incarcerated) and in the community. This information helps unit staff know the level of initial concern they should have and how to approach the person.
After 5 or 6 weeks, the case manager can complete Part 2. It reviews
- dynamic risk factors, including recent violence, substance use, negative or defiant attitude, and impulsive behaviour; and
- dynamic protective factors, including following rules and agreements, coping with problems and frustrations, having positive influences from their social network, and motivation for a crime-free future.
A multidisciplinary team then meets to complete Part 3. They draw conclusions about the level of concern for future violence inside prison, outside at discharge, and (when applicable) outside during potential leave.
Because the prison staff are not used to completing these types of evaluations, train-the-trainer sessions and masterclasses were held to help with the mandatory implementation.
Since its implementation in all 25 Dutch prisons in 2021, Part 1 has been completed about 30,000 times annually. The full screening has been completed about 10,000 times annually. This created a lot of data to analyze.
Among staff who completed user experience questionnaires during implementation, only 4% said the RS-V was very difficult to use, and 60% found it useful or very useful. Respondents cited improved internal prison safety as the greatest benefit, followed by better insights into risks and strengths of each person.
Predictive validity studies found the RS-V had good predictive validity to distinguish between people who would and would not be violent inside the prison within 4 months after the screening, and outside the prison within 12 months after release. The good predictive validity also shows there is room to better tailor risk management.
Risk Screener Youth
Dr. de Vries Robbé’s team collaborated with forensic care providers in youth prisons, outpatient care, and supervision to develop the Risk Screener Youth (RS-Y). After a pilot project at various youth organizations, it was launched nationally in the Netherlands.
Developed for young people ages 12 to 25 years, the professional version focuses on behaviour in the community. It reviews
- historical risk factors, including previous violence and non-violent crime;
- dynamic risk factors, including an unsafe home environment, criminality in the social network, substance use problems, antisocial attitudes or behaviours, anger management issues, and financial problems; and
- dynamic protective factors, including a supportive social network, rules and boundaries at home, following rules and agreements, coping skills, school or work, and motivation for change.
The conclusions rate the level of concern for violent behaviour toward others and non-violent criminal behaviour.
A user experience survey found that 62% of respondents found the RS-Y very or quite useful. The biggest benefits were listed were improving insight into youth profiles, enhancing intervention planning, and stimulating conversations with youth.
Additional youth self-assessment and network-assessment (for example, parents, teachers, good friends) versions bring more perspectives into the evaluation. They encourage conversations and collaborations.
Youth responding to a survey found that 66% were happy or very happy with the experience of completing the self-assessment and being asked about their own opinions.
While risk evaluations for youth are generally more challenging, the RS-Y has equally good predictive validity for identifying violence risk as comprehensive risk assessment tools.
For more details on risk screening, watch the recording of the April 3 lecture, “Feasible Risk Screening for Violence and Criminality in Adults and Youth with the RS-V and RS-Y. Why, When, for Whom, and Does It Work?” on our website.
Written by Virginia St-Denis and approved by Dr. Michiel de Vries Robbé.
