TY  - JOUR
PY  - 2018//
TI  - Structured risk assessment for reduction of multiple risk outcomes in a secure mental health setting: Use of the START
JO  - Criminal behaviour and mental health
A1  - Gunenc, Cevher
A1  - O'Shea, Laura E.
A1  - Dickens, Geoffrey L.
SP  - 61
EP  - 71
VL  - 28
IS  - 1
N2  - BACKGROUND: Structured risk assessment is commonly used in secure settings to aid prediction and prevention of risky behaviours; the expected benefits have rarely been investigated.  AIMS: The aim of the study is to determine whether adverse outcomes (physical and verbal aggression, self-harm, victimisation, self-neglect, unauthorised leave and substance abuse) reduced after patients were assessed with the Short-term Assessment of Risk and Treatability (START).  METHODS: In a naturalistic study, anonymised demographic and clinical information was collected from 50 male patients. Data included START assessment and frequency of target behaviour for 3 months before and after first assessment. Chi-square and linear mixed models analyses were used to determine whether there was any change in the behaviours of interest.  RESULTS: There were no significant changes in physical or verbal aggression over time, although a tendency towards fewer incidents was apparent. Other adverse behaviours were very infrequent at baseline, precluding adequate analysis.  CONCLUSIONS: In this small sample, START did not achieve its primary purpose of significant reduction in adverse behaviours. Although our sample size was informed by a power calculation, we may have over-estimated the size of anticipated change. Further, the 3-month comparison periods before and after the assessment follow-up period were rather short. Accordingly, we recommend more research on the value of this tool in practice rather than discontinuing its use. Copyright © 2017 John Wiley & Sons, Ltd.<p /> <p>Language: en</p>
LA  - en
SN  - 0957-9664
UR  - http://dx.doi.org/10.1002/cbm.2036
ID  - ref1
ER  -