Sir, – The psychologist Stephen Hart, a world authority on risk assessment tools and the co-developer of a number of the main risk assessment tools in current use, regularly reiterated the fact that these tools can only estimate risk; they cannot predict specific events and do not claim to do so.
I have contributed to the early introduction of risk assessments in both prisons and mental health settings through the clinical administration of formal, structured, risk assessment measures. One clear but often unacknowledged benefit in general mental health settings is that such structured measures can help to give a more accurate and often a lower estimate of a service user’s risk; thus in a number of cases it has supported long-term service users having greater periods (and/or degrees) of independent living than they had previously enjoyed.
Had such measures existed in the 1960s, they would have contributed significantly to lower numbers of people being assessed to needless detention in psychiatric institutions at a time when we had one of the highest rates of institutionalisation in the world.
This State could benefit by going in the direction that Northern Ireland has by introducing forensic psychiatric community teams to areas throughout the country as the focus should be on building upon current local risk-management strategies that would benefit from more accessible, integrated specialist knowledge and resources. The introduction of such teams would go some way in helping reduce the frequency of violent incidences perpetrated by the small minority of mental health service users who engage in violence at a level that may lead to very significant harm. Unfortunately there are no (and may never be) “crystal balls” to predict or “magic wands” to prevent a number of terrible events; such extreme violence as seen in Cobh will still occasionally occur, with devastating consequences for those affected. I send my condolences to the Greaney family at this very sad time. – Yours, etc,
EMMET MURRAY,
Forensic Clinical
Psychologist,
Letterkenny, Co Donegal.