ETHICAL ISSUES IN RISK ASSESSMENTS July 27, 2009.

ETHICAL ISSUES IN RISK ASSESSMENTS

July 27, 2009

Presented by:

Bruce E. Mapes, Ph.D.

PO Box 1028Exton, PA 19341

[email protected]

RISK - DEFINITION

• Risk is a “threat or hazard that isn’t completely understood and therefore can be forecast only with uncertainty.”

• Risk involves the ideas of “nature, severity, frequency, imminence, and likelihood – not just probability.”

definition

• Risk is “context specific”

• Risk is “never known but estimated.”

RISK ASSESSMENT IS:

• “Gathering information to assist in decision-making”.

• “An individualized process”

RISK ASSESSMENT ISN’T:

• “Simply providing a diagnosis or prognosis”

• “Simply considering a set of test items or risk factors determined before the evaluation.”

GOALS OF RISK ASSESSMENT

• To contain and reduce the individual’s risk.

• To guide interventions.

• To improve the consistency of decisions.

• To improve the transparency of decisions to protect the rights of the individual, as well as the community and potential victims.

ESTIMATING FIRST OFFENSE

• Intent

• Plan

• Means

• Opportunity

• Coin Toss

ESTIMATING RECIDIVISM

• History (static factors)

• Dynamic Factors

• Acute Factors

Your Perspective

LEVEL # % VOR

Low 900 30% 270

High 100 90% 90

DETECTION RATES

FREQ VICTIMS / 20 YRS

5 YRS 15 YRS 20 YRS

LOW 4 18.5% 47.8% 68.4%

HIGH 20 64.1% 96.1 99.7%

WHO IS MORE DANGEROUS?

• Adult male sex offender

– Selects young boy victims

– Selects young girls victims

RESEARCH CRITERION

• Re-arrest / hospitalization for anything

• Re-arrest / hospitalization for violence

• Charged for anything or new offense

• Convicted for anything or new offense

VICTIMIZATION STUDIES

Besserer and Trainor (2000)

• 78% of sexual assaults not reported to anyone.

• 59% “not important enough”

POLICE RECORDS

• 50% of sexual assault victims will report

• Incest victims unlikely to report first offense and almost never report the second

• Previous victims who went through the system unlikely to report a new offense

CLINICAL RECORDS

• Diagnoses to justify services

• Lack information about crimes

• Confidentiality

• Different providers

HOW CHARGED?

• Plea bargain = 25 victims become 1

• Specific offense may not be prosecuted

LENGTH OF FOLLOW-UP

• Highest number within first five years after release from prison

• In reality risk period may be 20 – 25 years

• Current studies 6 months to sixteen years

DEVIATIONS FROM GROUP

• For sex offending, the risk of sexual assaults increases to the age of 26 and then decreases to the age of 40, and it is almost nonexistent after the age of 60.

PA AGES AT CONVICTION(n = 6406)

• 63.7% < 40 years old

• 31 % = 41 – 60 years old

• 5.6 % > 60 (7 > 80 years)

SURVIVOR ANALYSIS

• 23% of the individuals receiving the same score as John on the Knapp Risk Assessment Protocol (KRAP) were re-arrested in 2 years, 34% were re-arrested in 5 years, and 43% were re-arrested in 10 years.

HOW DO WE REPORT RISK?

• Risk prediction (dichotomous)

• Risk Estimate (Survival analysis)

• Risk Statement

MENTAL HEALTH ISSUES

• There is no Axis 1 diagnosis with a significant relationship to violence.

• Iterative Classification Tree (Monahan)

SUBSTANCE ABUSE ISSUES

• May be related to first offense

• Recidivists more likely to have co-occurring Antisocial Personality Disorder

• Substance use may be a means, rather than the end.

FRONTAL LOBE ISSUES

• Frontal lobe impairment may increase risk for getting caught, rather than for violence.

THE PRIMARY QUESTIONS?

• To what degree does a person make a choice to be violent?

• To what degree does he or she not make a choice?

• If he or she does not make a choice, what do we do?