Structured versus unstructured judgment: DUNDRUM-1 compared to court decisions.

Authors :: Jeandarme I
Habets P
Kennedy H
Source :: International journal of law and psychiatry [Int J Law Psychiatry] 2019 May - Jun; Vol. 64, pp. 205-210. Date of Electronic Publication: 2019 May 01.
Publication Year :: 2019
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.<br />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.<br />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.<br />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.<br /> (Copyright © 2019 Elsevier Ltd. All rights reserved.)