title: Risk assessment instruments in clinical practice.
abstract: OBJECTIVE
  To determine whether the items in one of the most widely validated instruments of violence risk assessment, the Historical-Clinical-Risk Management-20 (HCR-20), are used in review board hearings to assess the risk of violence by people found Not Criminally Responsible on account of Mental Disorder (NCRMD).
  
  
  METHODS
  This study was conducted from October 2004 to August 2006 in Quebec's sole forensic psychiatric hospital and 2 large civil psychiatric hospitals designated for the care of people declared NCRMD in the Montreal metropolitan area. The risk assessments presented by clinicians at annual review board hearings and the boards' rationale for the release or detention of people found NCRMD were contrasted with the risk assessments conducted by the research team using the HCR-20. The final sample was comprised of 96 men.
  
  
  RESULTS
  Very few of the risk factors identified by prior research (HCR-20 items) were mentioned in the hearing process, whether in clinical reports, discussions during the hearing, or in the disposition justification.
  
  
  CONCLUSIONS
  The findings confirm that there remains a significant gap between research evidence and risk assessment practice.
authors.affiliation: Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec. gilles.cote@uqtr.ca
authors.forename: Gilles
authors.initials: G
authors.lastname: Côté
authors.forename: Anne G
authors.initials: AG
authors.lastname: Crocker
authors.forename: Tonia L
authors.initials: TL
authors.lastname: Nicholls
authors.forename: Michael C
authors.initials: MC
authors.lastname: Seto
mesh_terms: D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D005555:Forensic Psychiatry; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D007298:Insanity Defense / Q000706:statistics & numerical data*; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence / Q000523:psychology; D001523:Mental Disorders / Q000523:psychology; D028642:Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000523:psychology; D008875:Middle Aged; D010344:Patient Advocacy; D010351:Patient Discharge / Q000331:legislation & jurisprudence*; D011792:Quebec; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014754:Violence / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data