International survey of violence risk assessment practices: Presentation of Belgian data

Objective. Mental health professionals are routinely called upon to assess the violence risk presented by their patients, frequently aided by structured instruments. Though surveys of risk assessment and management have been conducted, these efforts have been largely circumscribed to individual countries and have not compared the practices of members of different professional disciplines.Method. A web-based survey was developed to examine the international use of structured instruments in the violence risk assessment process across five continents and to compare the perceived utility of such instruments by psychologists, psychiatrists, and nurses. The survey was translated into nine languages and distributed to members of 59 national and international organizations following the Dillman total Survey Design method.Belgium results. The Belgium sample was composed of 86 mental health professionals (69 psychologists, 12 psychiatrists, 1 nurse and 4 other professionals). Respondents had an average age of 43.93 years and 10.85 years of which was spend in practice. Over half of their time in the past 12 months was spent on clinical activities, most often in forensic hospitals followed by private practice and correctional institutions. Additional responsibilities over the past 12 months included administrative duties, teaching with comparatively little time being spent on research pursuits. Respondents reported having conducted an average of 211.68 violence risk assessment in their lifetimes, over half of which with the aid of a structured instrument. In the past 12 months, respondents conducted an average of 40.76 violence risk assessments, again over half of which using a structured instrument. Over both their lifetimes and the past 12 months, respondents reported that the instrument most commonly using in the violence risk assessment process were the: PCL-R (Psychopathy Checklist Revised; Hare 1991, 2003), the HCR-20 (Historical Clinical Risk; Webster, Douglas, Eaves, et Hart, 1997), the VRAG (Violence Risk Appraisal Guide; Quinsey, Harris, Rice et Cormier, 2006) and the SAPROF (Structured Assessment of PROtective Factors for violence risk; de Vogel, de Ruiter, Bouman, & de Vries Robb&2011). The PCL-R and the HCR-20 are the most used instruments. As for the perceived usefulness of these instruments by respondents, the utility for risk assessment was described as "quite useful" and "useful" for the PCL-R, HCR-20 and the SAPROF. The usefulness of the VRAG was more nuanced. To develop a violence risk management plan or implement violence risk management plan, the instruments were used less frequently, however, the HCR-20 was the instrument found most useful, followed by PCL-R and SAPROF. (C) 2015 Elsevier Masson SAS. All rights reserved.