Risicotaxatie gedaan: hoe nu verder? De vertaalslag van risicotaxatie naar risicomanagement

Introduction Risk management has been defined as all actions that are undertaken to minimize or neutralize the risk of recidivism. These actions can be divided into four aspects: treatment, monitoring, supervision and victim safety. Research and practice show that clinicians in forensic mental health care often experience difficulties to formulate a risk management plan based on diagnostic- and/or risk assessment instruments. This process can be divided in three steps: 1) Identification of risk and/or protective factors; 2) Construct a theory about their interdependence; 3) Formulate a risk management plan.
Methods In this study, we aimed to investigate the process of formulating a risk management plan in three ways. Firstly, a literature review was conducted to identify available methods than can be used for the formulation of a risk management plan. Secondly, a national survey among clinicians was published to investigate methods that are used for each of the three steps, and the difficulties that clinicians experience in this process. Thirdly, 16 in-depth interviews were conducted to gain more detailed information about the process of risk management. Results The literature review identified 21 methods that can provide some guidance in the process of formulating risk management plans. Fourth generation risk-assessment instruments are the most promising for this purpose. However, most methods do not cover all steps of the process and lack specific guidelines. Next, the survey and interviews showed that clinicians use many different methods and approaches to structure the three steps. However, clinicians experience many difficulties in this process, among which lack of training and guidelines, ICT-related problems, work pressure, and confusion of concepts.
Conclusion There are insufficient tools available to properly guide the translation from diagnostics and/or risk assessment to a risk management plan, and various difficulties are experienced by clinicians in the field. It is concluded that the forensic mental health care field is in need of a guide that structures and facilitates the process of Identification, Construction of Theory, and Risk Management.