Rethinking Risk Assessment: The MacArthur Study of Mental Disorder and Violence

Rating:
Summary: Seminal work on violence risk assessment and mental illness
Review: In detailing the largest and most significant research study of its type (i.e. The MacArthur Study of Mental Disorder and Violence), Rethinking Risk Assessment describes what is surely to become the seminal work in the area violence and mental illness. The authors point to the methodological flaws in many earlier studies that failed to establish clear links between mental illness and violence. It moves beyond previous studies to point to a clear link between serious mental illness and an increased risk of violence.

Although based upon a North American population (i.e. with its higher societal rates of violence generally) the size of the study, and the relationships it demonstrates suggest that this work has significant implications for other jurisdictions. The book illustrates tools clinicians can use to assist with identification of those with higher for risk of violence.

Although actuarial methods do not offer a panacea for problems associated with risk prediction, they nevertheless provide pointers for increasing the precision with which such assessments can be made. Monahan et. al. acknowledge the limitations of such methods, and point to the complexity of clinical risk assessment for violence potential. The authors also point to the broader contextual, and problematic issues associated with false positives and negatives, in terms of prediction.

Armed with the information contained within this text, clinical staff will have a thorough grounding in the most up to date evidence in the field. This should provide a solid foundation from which staff can approach the complex issue of considering risk assessment generally.