Product Description

The presumed link between mental disorder and violence has been the driving force behind mental health law and policy for centuries. Legislatures, courts, and the public have come to expect that mental health professionals will protect them from violent acts by persons with mental disorders. Yet for three decades research has shown that clinicians' unaided assessments of "dangerousness" are barely better than chance. Rethinking Risk Assessment: The MacArthur Study of Mental Disorder and Violence tells the story of a pioneering investigation that challenges preconceptions about the frequency and nature of violence among persons with mental disorders, and suggests an innovative approach to predicting its occurrence. The authors of this massive project -- the largest ever undertaken on the topic -- demonstrate how clinicians can use a "decision tree" to identify groups of patients at very low and very high risk for violence. This dramatic new finding, and its implications for the every day clinical practice of risk assessment and risk management, is thoroughly described in this remarkable and long-anticipated volume. Taken to heart, its message will change the way clinicians, judges, and others who must deal with persons who are mentally ill and may be violent will do their work.

Product Details

• Amazon Sales Rank: #320186 in Books
• Published on: 2001-03-15
• Original language: English
• Binding: Hardcover
• 197 pages

Review
"This all-star team of scholars has taken violence research to a new level. At once grand yet humble, this book is elegantly written about research that is brilliantly conceived. Research just doesn't get any better than this. This book will be a godsend to clinicians who want practical tools to help their clients live safer lives." -- Joel A. Dvoskin, PhD, ABPP (Forensic), University of Arizona Colleges of Law and Medicine

"This highly readable book discusses the largest and most comprehensive study ever done or likely to be done on violence prediction among people with mental illness. This state-of-the-art study by an outstanding team of experts challenges the common belief that serious mental disorder predisposes people to behave violently. This work offers oan actuarial tool that will fundamentally alter clinical practice with regard to risk assessment. No one will be able to claim expertise in this area without reading this book." -- Marnie E. Rice, PhD, Professor of Psychiatry and Behavioral Neurosciences, McMaster University

"If it were possible to envision the ideal study of violence by persons with mental disorder -- carefully conceptualized, generously supported, large and multi-site, and meticulously measured and analyzed -- this is such a study. It represents a staggering accomplishment. Unprecedented in their scope, these findings challenge some aspects of the conventional wisdom in this area and support other, yielding both invaluable empirical information and practical assistance in risk assessment. The authors have provided essential knowledge for researchers, clinicians, administrators, attorneys, judges, and those who make and implement policy in this area." -- Kirk Heilbrun, PhD, MCP Hahnemann University

"Rethinking Risk Assessment is an instant classic in forensic mental health, destined to become required reading for practitioners, as well as for smart administrators, lawyers, and policy-makers. It will have an immediate and profound impact on the way that mental health professionals assess violence risk. Although the research focuses on violence committed by mentally ill people released from civil psychiatric hospitals, the findings are relevant to professionals working in diverse settings. Practitioners who read the book may discover that some of the findings are consistent with their clinical experience, whereas other challenge conventional wisdom; regardless, as its title suggests, this book will force practitioners to reconsider the procedures they use to assess violence risk." -- Stephen Hart, PhD, Simon Fraser University

"This book describes the best-designed study that has ever been done on violence risk assessment. Dr. Monahan and his co-authors have done an amazing job and accomplished their goal of overcoming many of the methodological obstacles of prior research. They present an approach to violence risk assessment that incorporates multiple models of risk assessment and has the potential to improve the accuracy of assessing the violence risk of patients whom we evaluate in our daily clinical practices." -- Renee Binder, MD, University of California, San Francisco

"This is an impressive piece of research."--Modern Law Review

"The MacArthur study is set to become the gold standard for research in this area...we can only hope that the impressive research reported in this book has the impact it deserves."--The Modern Law Review

"...thoughtful, cogent, and likely to be a road map for years to come...By any measure, this book is a classic."--Psychiatric Services

"Ten years in the making, Rethinking Risk Assesment turns previous risk assessment methods on their heads. Their analysis is thoughtful, cogent, and likely to be a road map for years to come. By any measure, this book will be a classic."--Psychiatric Services

Book Info
Tells the story of a pioneering investigation challenging preconceptions about the frequency and nature of violence among persons with mental disorders, and suggests an innovative approach to predicting its occurrence. Demonstrates how clinicians can use a decision tree to identify groups of patients at low and high risk for violence. DNLM: Mental Disorders--diagnosis.

From the Publisher
5 line illus.

Customer Reviews

Seminal work on violence risk assessment and mental illness
In detailing the largest and most significant research study of its type (i.e. The MacArthur Study of Mental Disorder and Violence), Rethinking Risk Assessment describes what is surely to become the seminal work in the area violence and mental illness. The authors point to the methodological flaws in many earlier studies that failed to establish clear links between mental illness and violence. It moves beyond previous studies to point to a clear link between serious mental illness and an increased risk of violence.

Although based upon a North American population (i.e. with its higher societal rates of violence generally) the size of the study, and the relationships it demonstrates suggest that this work has significant implications for other jurisdictions. The book illustrates tools clinicians can use to assist with identification of those with higher for risk of violence.

Although actuarial methods do not offer a panacea for problems associated with risk prediction, they nevertheless provide pointers for increasing the precision with which such assessments can be made. Monahan et. al. acknowledge the limitations of such methods, and point to the complexity of clinical risk assessment for violence potential. The authors also point to the broader contextual, and problematic issues associated with false positives and negatives, in terms of prediction.

Armed with the information contained within this text, clinical staff will have a thorough grounding in the most up to date evidence in the field. This should provide a solid foundation from which staff can approach the complex issue of considering risk assessment generally.