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

by John Monahan, Henry J. Steadman, Eric Silver, Paul S. Appelbaum, Pamela Clark Robbins, Edward P. Mulvey, Loren H. Roth, Thomas Grisso, Steven Banks

Overview

The presumed link between mental disorder and violence has been the driving force behind mental health law and policy for centuries. Legislatures, courts, and the public have come to expect that mental health professionals will protect them from violent acts by persons with mental disorders. Yet for three decades research has shown that clinicians' unaided assessments of "dangerousness" are barely better than chance. Rethinking Risk Assessment: The MacArthur Study of Mental Disorder and Violence tells the story of a pioneering investigation that challenges preconceptions about the frequency and nature of violence among persons with mental disorders, and suggests an innovative approach to predicting its occurrence. The authors of this massive project -- the largest ever undertaken on the topic -- demonstrate how clinicians can use a "decision tree" to identify groups of patients at very low and very high risk for violence. This dramatic new finding, and its implications for the every day clinical practice of risk assessment and risk management, is thoroughly described in this remarkable and long-anticipated volume. Taken to heart, its message will change the way clinicians, judges, and others who must deal with persons who are mentally ill and may be violent will do their work.

Product Details

ISBN-13:	9780190286019
Publisher:	Oxford University Press
Publication date:	03/01/2001
Sold by:	Barnes & Noble
Format:	eBook
File size:	3 MB

Table of Contents

1. Violence Risk Assessment: The Law and the Science
2. Violence Among Patients in the Community
3. Testing "Criminological" Risk Factors
4. Testing "Clinical" Risk Factors
5. Customizing Risk Assessment
6. Combining Customized Risk Assessment to Produce the Best Estimate of Risk
7. Violence and the Clinician: Assessing and Managing Risk
Appendix A. The MacArthur Violence Risk Assessment Study: Methods
Appendix B. Risk Factors and Associations with Violence

Editorial Reviews

"This all-star team of scholars has taken violence research to a new level. At once grand yet humble, this book is elegantly written about research that is brilliantly conceived. Research just doesn't get any better than this. This book will be a godsend to clinicians who want practical tools to help their clients live safer lives." — Joel A. Dvoskin, PhD, ABPP (Forensic), University of Arizona Colleges of Law and Medicine

"This highly readable book discusses the largest and most comprehensive study ever done or likely to be done on violence prediction among people with mental illness. This state-of-the-art study by an outstanding team of experts challenges the common belief that serious mental disorder predisposes people to behave violently. This work offers oan actuarial tool that will fundamentally alter clinical practice with regard to risk assessment. No one will be able to claim expertise in this area without reading this book." — Marnie E. Rice, PhD, Professor of Psychiatry and Behavioral Neurosciences, McMaster University

"If it were possible to envision the ideal study of violence by persons with mental disorder — carefully conceptualized, generously supported, large and multi-site, and meticulously measured and analyzed — this is such a study. It represents a staggering accomplishment. Unprecedented in their scope, these findings challenge some aspects of the conventional wisdom in this area and support other, yielding both invaluable empirical information and practical assistance in risk assessment. The authors have provided essential knowledge for researchers, clinicians, administrators, attorneys, judges, and those who make and implement policy in this area." — Kirk Heilbrun, PhD, MCP Hahnemann University

"Rethinking Risk Assessment is an instant classic in forensic mental health, destined to become required reading for practitioners, as well as for smart administrators, lawyers, and policy-makers. It will have an immediate and profound impact on the way that mental health professionals assess violence risk. Although the research focuses on violence committed by mentally ill people released from civil psychiatric hospitals, the findings are relevant to professionals working in diverse settings. Practitioners who read the book may discover that some of the findings are consistent with their clinical experience, whereas other challenge conventional wisdom; regardless, as its title suggests, this book will force practitioners to reconsider the procedures they use to assess violence risk." — Stephen Hart, PhD, Simon Fraser University

"This book describes the best-designed study that has ever been done on violence risk assessment. Dr. Monahan and his co-authors have done an amazing job and accomplished their goal of overcoming many of the methodological obstacles of prior research. They present an approach to violence risk assessment that incorporates multiple models of risk assessment and has the potential to improve the accuracy of assessing the violence risk of patients whom we evaluate in our daily clinical practices." — Renée Binder, MD, University of California, San Francisco

From the Publisher