Citation

Murphy D. Crim. Behav. Ment. Health 2002; 12(2): 169-178.

Affiliation

South London and Maudsley NHS Trust, Department of Forensic Psychiatry, London, UK. Drdjmurphy@aol.com

Copyright

(Copyright © 2002, John Wiley and Sons)

DOI

unavailable

PMID

12459817

Abstract

INTRODUCTION: Risk assessment occupies an increasingly important position in psychiatry. This paper contends that collective judgement is the optimal method of assessing risk. THE MEANING OF RISK: Risk has a dual meaning: emotional and judgemental. RISKS FACED BY STAFF: Assaults, threats and survival anxiety. THE EFFECTS OF DANGER ON THE GROUP: Staff wariness and resistance, attribution of blame. THE AMBIGUOUS TASK: For a group to function well it must have a clear task. Custodial roles can lead to ambiguity. THE EMOTIONS OF LARGER GROUPS: Externally directed hostility, internal homogenization of views. SOCIAL DEFENCES: Rituals can develop in forensic institutions, as well as militarism. ANTI-THERAPEUTIC CULTURE: Sadism may develop where a marked power differential develops. THE ROLE OF THE LEADER: Danger intensifies the feelings about leaders, perhaps idealization, perhaps disaffection. Leaders and others need to agree on risk assessment or fragmentation will occur. THE MODIFICATION OF RISK: The assessment of risk may modify it. Mutual hostility must be reduced. Dialogue and understanding are needed. A CLIMATE FOR RISK ASSESSMENT: The environment should be less authoritarian and more democratic, so that patients can join a group and internalize its values. Reflective space is also required. CONCLUSIONS: Risk assessment is best described in terms of human endeavour, not in the language of scientific measurement.

Language: en