Structured versus unstructured judgment: DUNDRUM-1 compared to court decisions. (May 2019)

• Record Type: Journal Article
• Authors: Jeandarme, Inge; Habets, Petra; Kennedy, Harry
• Is Part Of: International journal of law and psychiatry. Volume 64(2019)
• Page Start: 205
• Page End: 210
• Publication Date: 2019-05
• Subjects: Forensic psychiatry -- Court decision -- Security level -- DUNDRUM-1; Forensic psychiatry -- Periodicals; Insanity (Law) -- Periodicals; Criminal psychology -- Periodicals; Forensic Psychiatry -- Periodicals; Psychiatrie médico-légale -- Périodiques; Aliénation mentale -- Périodiques; Gerechtelijke psychiatrie; Electronic journals; 614.15
• DOI: 10.1016/j.ijlp.2019.04.006
• Languages: English
• ISSNs: 0160-2527

Abstract

Abstract: Background: Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Courts largely rely on the evaluations of the prison psychiatrists and psychologists to form their decision. None of the few available instruments – e.g., the DUNDRUM-1 – is currently used to provide structured clinical judgment when determining security level. Method: DUNDRUM-1 scores were collected for 150 forensic patients. Security levels according to DUNDRUM-1 assessment were compared to security levels as decided by the court. Results: There was little agreement between DUNDRUM-1 scores and proposals for secure care made by the court. The DUNDRUM-1 predicted eventual admission to a high security setting, but not a medium security setting. Conclusion: The DUNDRUM-1 is an instrument that can help clinicians and judges to make more reliable and transparent decisions regarding secure care. However, further research with regard to practical applicability is needed.