Violence risk instruments may be culturally unsafe for use with Indigenous patients

Abstract

Objective:

Violence risk assessment assumes a critical medico-legal role addressing offender/patient needs and informing forensic mental health decision making. Yet questions remain over the cross-cultural applicability of such measures. In their current form, violence risk instruments may not reflect the unique life and cultural experiences of Indigenous Australians rendering them culturally unsafe.

Conclusions:

To realize equitable forensic assessment, it is necessary to ascertain whether there are cultural differences across risk factors for violence and that risk instruments are validated as culturally appropriate. Greater cross-cultural rigour in forensic mental health risk assessment, research and practice is proposed.

Keywords

violence risk assessment forensic psychiatry cross-cultural psychiatry forensic mental health Indigenous Australians

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References

Hanson

Thornton

Improving risk assessments for sex offenders: a comparison of three actuarial scales. Law Hum Behav 2002; 24: 119–136.

Andrews

Bonta

Wormith

SJ.

The level of service/case management inventory (LS/CMI). Toronto: Multi-Health Systems, 2003.

Quinsey

Harris

Rice

. Violent offenders: appraising and managing risk. 2nd ed. Washington, DC: American Psychological Association, 2006.

Douglas

Hart

Webster

. HCR-20V3: assessing risk of violence – user guide. Burnaby, BC: Mental Health, Law, and Policy Institute, Simon Fraser University, 2013.

Hare

RD.

Manual for the Hare psychopathy checklist-revised. 2nd ed. Toronto: Multi-Health Systems, 2003.

Olver

Stockdale

Wormith

JS.

Thirty years of research on the level of service scales: a meta-analytic examination of predictive accuracy and sources of variability. Psychol Assess 2014; 26: 156–176.

Singh

Grann

Fazel

A comparative study of violence risk assessment tools: a systematic review and metaregression analysis of 68 studies involving 25,980 participants. Clin Psychol Rev 2011; 31: 499–513.

Yang

Wong

SCP

Coid

The efficacy of violence prediction: a metaanalytic comparison of nine risk assessment tools. Psychol Bull 2010; 136: 740–767.

Holsinger

Lowenkamp

Latessa

EJ.

Exploring the validity of the Level of Service Inventory Revised with Native American offenders. J Criminal Justice 2006; 34: 331–337.

10.

Shepherd

Singh

Fullam

Does the youth level of service/case management inventory generalize across ethnicity?

Int J Forensic Mental Health 2015; 14: 193–204.

11.

Wilson

Gutierrez

Does one size fit all? A meta-analysis examining the predictive ability of the level of service inventory (LSI) with Aboriginal offenders. Criminal Justice Behav 2014; 41: 196–219.

12.

Wormith

Hogg

Guzzo

The predictive validity of the LS/CMI with Aboriginal offenders in Canada. Criminal Justice Behav 2015; 42: 481–508.

13.

Zhou

Witt

Xiang

. Violence risk assessment in psychiatric patients in China: a systematic review. Aust N Z J Psychiatry 2016; 50: 33–45.

14.

Ewert v Canada [2015] FC 1093.

15.

King

Smith

Gracey

Indigenous health part 2: the underlying causes of the health gap. Lancet 2009; 374: 76–85.

16.

Henry

Houston

Mooney

GH.

Institutional racism in Australian healthcare: a plea for decency. Med J Aust 2004; 180: 517–520.

17.

Shepherd

Phillips

Cultural “inclusion” or institutional decolonisation? How should prisons address the mental health needs of Indigenous prisoners?

Aust N Z J Psychiatry 2016; 50: 307–308.

18.

Mals

Howells

Day

. Adapting violence rehabilitation programs for the Australian Aboriginal offenders. J Offender Rehab 2000; 30: 121–135.

19.

Shepherd

SM.

Finding color in conformity: a discourse on culturally specific risk factors for violence in Australia. Int J Offender Ther Comp Criminol 2015; 59: 1297–1307.

20.

Swan

Raphael

Ways forward: national Aboriginal and Torres Strait Islander mental health policy. National consultancy report, 1995. Canberra: Australian Government Publishing Service.

21.

Westerman

TG.

Engagement of Indigenous clients in mental health services: what role do cultural differences play?

Aust e-J Adv Mental Health 2004; 3: 88–93.

22.

Heffernan

Andersen

Kinner

SA.

Enhancing research quality through cultural competence: a case study in Queensland prisons. Australas Psychiatry 2015; 23: 654–657.

23.

Walker

Schultz

Sonn

Cultural competence – transforming policy, services, programs and practice. In: Dudgeon

Milroy

Walker

(eds) Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd ed. Canberra: Australian Government Department of the Prime Minister and Cabinet, 2014, pp.195–220.

24.

National Health and Medical Research Council. Values and ethics: guidelines for ethnical conduct in Aboriginal and Torres Strait Islander health research. Canberra: Commonwealth of Australia, 2003.

25.

Royal Australian and New Zealand College of Psychiatrists. Principles and guidelines for Aboriginal and Torres Strait Islander mental health. Ethical guideline 11, www.ranzcp.org/Files/Resources/College_Statements/Ethical_Guidelines/GDL-11-PPC-Principles-and-Guidelines-for-Aborigina.aspx (2014, accessed February 2016).