Most forensic psychologists have adopted clinical assessment to determine the dangerousness of a patient to commit suicide. However, several academicians have encouraged the practitioners to adopt an actuarial method in determining the patient’s dangerousness level. However, Litwak (2001) insists that there is no statistical difference between the actuarial and the clinical assessment. The Violence Risk Appraisal Guide (VRAG) has not been validated to make it more reliable in determining a person’s dangerousness. The opponent of the clinical assessment indicates that dangerousness assessment is inherently different from other risks making it difficult to compare with the clinical assessment. Adopting the actuarial assessment allows the organization to consider change dynamics, like clinical variables, personality, and human judgment. Although clinicians should adopt actuarial assessment, they should consider relevant and meaningful available data. Other clinical assessment methods such as HCR-20 Can also determine the dangerousness level. Litwack (2001) indicates that HCR-20 has a high predictability score. Showing that more than 45% of the patients assessed through the model committed physical violence within two years. Using the Salient factor scales facilitates 65% prediction, while the recidivism Prediction score has an assessment score of 76%. The average clinical assessment to determine recidivism was 56%, while the actual assessment had a prediction rate of 71%. Medical practitioners should adopt diverse approaches to evaluating the patients’ dangerousness and not rely on a single method.
The medical practitioners can adopt different approaches to analyze patients’ concerns to ensure the productions are reliable. The article recommends that practitioners utilize different assessment approaches to determine the patient’s danger rather than solely relying on actuarial or clinical methods (Saya et al., 2019). The clinical assessment integrates variables like personality, while the actuarial; assessment integrates historical variables. The forensic psychologist can adopt the clinical and actuarial assessments to determine whether a patent with a personality disorder who committed a one-time mistake should be placed in involuntary hospitalization. One specific case where actuarial and clinical assessment is vital is when determining a sixteen-year-old person with ADHD, and non-verbal learning disorder should be placed under involuntary hospitalization. During the clinical assessment, personality variables such as violence, aggressiveness, impulsiveness, and hypermania characteristics will be evaluated using Clinical assessment tools like RPS. The historical aspects such as the frequency of threatening harm to others, the rate of hypomanic episodes, the level of range with the close contacts like families and friends, and the frequency of punching walls and throwing vases can be analyzed using actuarial tools like VGRA.
The article encourages psychologists in forensics to avoid relying on VGRA and other actuarial assessments assuming they are more effective and accurate. Adopting a multi-factor assessment help ensure patients more susceptible to danger and committing suicide are identified and helped promptly. The clinical and actuarial assessment to determine dangerousness can also be adopted by psychology forensics to determine whether patients with schizophrenia should be placed in involuntary care. Adopting a relevant and reliable assessment allows the patient to receive quality s mental care services that restore their wellbeing and safety (Pozzulo et al., 2021). Most patients consider involuntary hospitalization to be effective when they are treated warmly and respectfully.
In conclusion, psychology forensics should adopt clinical and actual assessments to determine a patient’s dangerousness. Relying on a single assessment may result in an unreliable outcome. Practitioners must provide a structured setting that allows patients to engage the support system to enhance their mental and emotional wellbeing. Relying on single evaluation criteria affects patient identification leading to hospitalization of patients with low recidivism at the expense of those with high suicide scores.
Litwack, T. R. (2001). Actuarial versus clinical assessments of dangerousness. Psychology, Public Policy, and Law, 7(2), 409.
Pozzulo, J., Bennell, C., & Forth, A. (2021). Forensic psychology. Psychology Press.
Saya, A., Brugnoli, C., Piazzi, G., Liberato, D., Di Ciaccia, G., Niolu, C., & Siracusano, A. (2019). Criteria, procedures, and future prospects of involuntary treatment in psychiatry around the world: a narrative review. Frontiers in psychiatry, 10, 271.