Preventative Detention & Extended Supersion

1. Preventative Detention & Extended Supersion Dr. C. J. Lennings

2. Summary • Preventative detention requires the psychologist • to make assessments of likely risk and • to comment on the likely outcome (and availability) of treatment services to link with extended supervision for high risk offenders in the community. • Both requirements present challenges to psychological practice. My talk outlines the practical and research challenges to psychologists exercising their skills in preventative detention matters.

3. Actuarial Risk Assessment • The most frequently used actuarial risk assessment device is the Static 99. In 21 of 22 studies the Static 99 successfully (if moderately) predicted re-offence. Its predictive accuracy, as assessed by Receiver Operating Characteristics lies between AUC=.65 to AUC =.75, indicating that a recidivist is between 65% and 75% more likely than a non recidivists to have a higher Static 99 score. But what actually does that mean?

4. In the universe of all possible decisions chance means you get it right 50% of the tme Correct Decision Wrong Decision

5. What does this mean • Predictive accuracy assessed through Receiver Operator Characteristics (ROC) assess the accuracy of an instrument by reference to chance. • If a scale assesses no better than chance it has an ROC score of .5 (equally right or wrong). If less than chance its ROC score is less than 0.5 and if greater than chance, the ROC score is greater than .5. • Typically, actuarial measures achieve predictive accuracy scores in the .65 to .75 region (moderate accuracy).

6. The Trade-off • However, the trade off between sensitivity and specificity on risk scores has to be acknowledged. For instance, if a score on the Static 99 of more than 5 is set as maximising predictive accuracy on the STATIC 99 it will correctly reject 93% of non-recidivists, but falsely reject 65% of recidivists. To counter the conservatism, by using a low risk score of 2, 92% of recidivists would be correctly classified but 55% of non-recidivists would be falsely classified as recidivists. (On the static 99 high risk is indicated by a score of 6 or more).

7. To err or not to err • Theoretical Properties. • Only 7% of non-recidivists will be falsely classified as recidivist with cut-of scores of 6 or more. • However 65% of recidivists will fail to be detected. • The error is more one is likely to miss a repeat offender than falsely classify a non-recidivist as a recidivist.

8. Decision Making Model: Static 99 =6 Risk Assessment prediction High Low Yes Correct (Hit) 35% Miss 65% Recidivist False Alarm 7% Correct Rejection 93% No

9. Decision Making: Static = 2 Risk Assessment prediction High Low Yes Correct (Hit) 92% Miss 8% Recidivist False Alarm 55% Correct Rejection 45% No

10. Triangulation • To help decide between a miss, hit and false alarm we can use dynamic factors. • Dynamic risk factors reflect those behaviours or events that have been either shown on the basis of experience, or theory development, to effect offending rates, but are different from Static factors, in that dynamic factors are subject to change as a result of life experience, treatment and transformational personality change.

11. Dynamic Assessment • Dynamic factors include such things as elements of the modus operandi of the offending pattern (eg escalation in offence, number of types of offences), attitudes, and background personality factors such as impulsivity, aggression, behaviours like substance use, emotional control and emotional regulation. Various instruments exist to measure dynamic factors, and a recent review of risk assessment instruments by Hanson (2007) indicated reasonable effectiveness for them.

12. The assessment process • Essentially risk assessment proceeds through using multiple risk assessment strategies (actuarial plus dynamic risk assessment, modus operandi assessment; personality assessment) and arrives at an estimate of the likelihood of recidivism. There are two key issues for Courts in this last sentence.

13. The first is that any risk assessment is probabilistic, and has significant error built into it, and • secondly, the estimate is an estimate of the likelihood of occurrence of an offence, but not the nature of the offence. In a situation where a specific offence (a serious sexual offence) is the subject of the inquiry, risk assessments, on the while do not consider severity of the offence. • Indeed, one reason they do not is that severity is not a useful factor (it is not related to later recidivism), but also the data we work with is not partialed into serious and non-serious offences.

14. Treatment • At the heart of the dilemma for psychologists who work in this field is the ethical or professional dilemma posed by identifying someone as high risk, but not being able to offer to that person a treatment that might meet the person’s needs if they are to be released into the community rather than detained for a crime they might commit, but we are not sure.

15. Emma Collins Research • Without going into chapter and verse, the best way to describe the results are “promising” recognising that many such programs are either based on moderate risk offenders, or exist as after-care treatment programs for offenders who have completed a period of rehabilitation in gaol. Only one of the studies she was able to find was conducted in Australia (in Victoria).

17. The problem • To date a mix of a failure of funding, poor cooperation between private and government services, poor cross disciplinary opportunities for cooperation, and stigma seem to block the provision of effective treatment for high risk (or even moderate risk) offenders.

18. In conclusion • I think many of my colleagues believe that high risk offenders will need a mix of group and individual treatment, liaison with private psychiatry over medication, liaison with Corrective Services over intensity of supervision, liaison with welfare groups such as housing support services and possibly with mental health over psychiatric involvement.