Determining security level in forensic psychiatry: a tug of war between the DUNDRUM toolkit and the HoNOS-Secure |
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Authors: | Petra Habets Inge Jeandarme Harry G Kennedy |
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Institution: | 1. Knowledge Centre Forensic Psychiatric Care (KeFor), Public Psychiatric Hospital Rekem, Rekem, Belgium petra.habets@opzcrekem.be https://orcid.org/0000-0001-9184-517X;3. Knowledge Centre Forensic Psychiatric Care (KeFor), Public Psychiatric Hospital Rekem, Rekem, Belgium https://orcid.org/0000-0002-1682-435X;4. National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Ireland https://orcid.org/0000-0003-3174-3272 |
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Abstract: | ABSTRACT Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Research regarding the assessment of security level is minimal, and limited instruments are available. This study investigated the instruments that measure the need for security level: DUNDRUM-1 and the HoNOS-Secure. The psychometric properties of the DUNDRUM-1, DUNDRUM-2 and the HoNOS-Secure were investigated. A random selection was made of 100 male forensic patients in prison. The DUNDRUM-1, DUNDRUM-2 and the HoNOS-Secure were scored retrospectively. A subsample of the files was rated by four researchers (n?=?38). Comparisons were made with the security level as decided by the court. The DUNDRUM-1 achieved excellent inter-rater reliability, and the HoNOS-Secure and DUNDRUM-2 got a moderate score. The internal consistency was highest for DUNDRUM-1 followed by the HoNOS-Secure and was low for the DUNDRUM-2. Both the DUNDRUM-1 and the HoNOS-Secure predicted allocations by the court to high security. The DUNDRUM-1 outperforms the HoNOS-Secure on psychometric properties and provides clear instructions with regard to the assessment of the security level. Training seems to be important for scoring the DUNDRUM-1. The current study provided more evidence for the applicability of the DUNDRUM-1 in Belgian settings with regard to determining the need for security. |
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Keywords: | Forensic mental health security level reliability DUNDRUM toolkit HoNOS-Secure |
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