The British Journal of Psychiatry (2008) 192: 384-387. doi: 10.1192/bjp.bp.107.044065
© 2008 The Royal College of Psychiatrists
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Predicting violent reconvictions using the HCR–20

Nicola S. Gray

School of Psychology, Cardiff University, and South Wales Forensic Psychiatric Service, Mid Glamorgan

John Taylor

Partnerships in Care, Borehamwood

Robert J. Snowden

School of Psychology, Cardiff University, Cardiff, UK

Correspondence: Nicola S. Gray, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK. Email: grayns{at}cardiff.ac.uk

Declaration of interest

None.

Background

Risk assessment of future violent acts is of great importance for both public protection and care planning. Structured clinical assessments offer a method by which accurate assessments could be achieved.

Aims

To test the efficacy of the Historical, Clinical and Risk Management Scales (HCR–20) structured risk assessment scheme on a large sample of male forensic psychiatric patients discharged from medium secure units in the UK.

Method

In a pseudo-prospective study, 887 male patients were followed for at least 2 years. The HCR–20 was completed using only pre-discharge information, and violent and other offending behaviour post-discharge was obtained from official records.

Results

The HCR–20 total score was a good predictor of both violent and other offences following discharge. The historical and risk sub-scales were both able to predict offences, but the clinical sub-scale did not produce significant predictions. The predictive efficacy was highest for short periods (under 1 year) and showed a modest fall in efficacy over longer periods (5 years).

Conclusions

The results provide a strong evidence base that the HCR–20 is a good predictor of both violent and non-violent offending following release from medium secure units for male forensic psychiatric patients in the UK.




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R. J. Snowden, N. S. Gray, J. Taylor, and S. Fitzgerald
Assessing Risk of Future Violence Among Forensic Psychiatric Inpatients With the Classification of Violence Risk (COVR)
Psychiatr Serv, November 1, 2009; 60(11): 1522 - 1526.
[Abstract] [Full Text] [PDF]

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