Conducting a risk assessment in your workplace will allow you to minimize risks, better comply with workplace safety regulations and help you to create and maintain a healthier work environment. The employer is responsible for removing all barriers to safe work. Allegations of unsafe working conditions and injury on the job can be expensive once the legal and social costs are tallied.
There are similar statistics from health and criminal justice settings and from community samples.
With the growth of offending behaviour programmes in the criminal justice system and the expansion of personality disorder services in the NHSboth criminal justice and healthcare systems are devoting considerable resources to discovering the extent to which mental health treatments can reduce the offending risk associated with antisocial personality disorder.
However as will be apparent throughout this chapter, it should be cautioned that there is more research on risk assessment than on risk management. Until such evidence emerges it is necessary to keep expectations of health service interventions around risk within reasonable bounds.
Introduction The diagnosis of antisocial personality disorder, like some other mental disorders, is associated with an increased risk of offending behaviour, including violence. However, antisocial personality disorder is a very broad diagnostic category see DSM -IV; APA,even when compared with other diagnoses in mental health.
It encompasses people who never commit offences as well as a minority who commit the most serious crimes, with a great range in between. As a result the diagnosis alone is of little value as an indicator of violence risk. The clinical assessment of violence risk in antisocial personality disorder is more problematic than in some other mental disorders, such as schizophrenia, because antisocial personality disorder lacks unequivocal symptoms such as delusions and hallucinations.
The clinical interview and mental state examination are therefore less reliable as a means of assessing the severity of the disorder.
Some patients may be both persuasive and deceptive, making a clinical interview a poor guide to the severity of the disorder and its associated risks.
Therefore much effort has been expended on the development and evaluation of tools that may assist in the assessment of violence risk.
Any measure that discriminates between degrees of severity of antisocial personality disorder is likely to be of assistance in risk assessment; the Psychopathy Checklist Hare, ; Hart, ab is therefore one of the most useful instruments in this field.
The statistical evaluation of risk assessment tools Risk assessment is concerned with probability, therefore it lends itself to a statistical approach comparing prediction and outcome. In order to evaluate risk assessment tools it is necessary to appraise the extent to which they maximise the detection of violent outcomes true positives while minimising the number of false alarms false positives.
Table 20 sets out the model for the possible outcomes of violence risk prediction. Possible outcomes of violence risk prediction. In this model the quality of the test or tool is judged by two main criteria: There is a trade-off between these measures.
As the test or tool is made less stringent by lowering the cut-off score it picks up more true positives sensitivity rises but it also picks up more false positives specificity falls.
The ideal is to maximise sensitivity while keeping specificity high. It is known that women in this population have depression, but the test detects only 90 true positivesleaving 10 undetected false negatives. It is also known that women do not have depression, and the test correctly identifies of these true negativesbut classifies incorrectly as having depression false positives.
Figure 3 An example ROC curve. In reality that is never achieved, but the area under the curve AUC measures how close the tool achieves the ideal. A perfect test would have an AUC of 1 and anything above 0. The AUC is the preferred statistic for evaluating risk assessment tools and is the most common metric used in such studies Mossman, Its main advantage, in comparison with the other statistics, is that such estimates appear not to be affected by the base rate of the phenomenon under consideration, which in this case is violence see Mossman, For these reasons, the review below uses AUC to compare tools used for violence risk assessment.
Statistical prediction and healthcare While the AUC is used because it is generally agreed to be the best available statistic Mossman,practitioners should be wary of the uncritical application of statistical approaches to risk assessment and management in a health setting.
The main problems are set out below. Statistics take no account of the values that are central to healthcare: The AUC statistic is concerned with maximising the number of right decisions.
As violence is relatively unusual in mental health populations, Monahan pointed out that the best way to be right most of the time is to predict that no patients will be violent.
That course of action is unacceptable because errors in medicine come with values attached and their values are not equal.
The consequences of failing to predict an act of serious violence a false negative are very different from the consequences of wrongly predicting violence a false positive. Fulford and colleagues have written extensively on the importance of values in mental health; for the purposes of this discussion the crucial point is that the statistics cannot be considered in isolation.Pros and Cons of Informal Assessments May 7, by mlicausi 3 Comments In any classroom there are two basic ways you can pre-assess your students’ level of .
Benefits of Workplace Risk Assessments Conducting a risk assessment in your workplace will allow you to minimize risks, better comply with workplace safety regulations and help you to create and maintain a healthier work environment. Dunn and Mulvenon distinguish between formative assessments, or “assessments designed to monitor student progress during the learning process (i.e., assessment for learning)” and formative evaluations.
An informal employee assessment takes place when an employee needs positive or constructive feedback, not necessarily at regularly scheduled intervals, as is the case with formal evaluations.
Some company leaders view an informal review as a better way to create ongoing feedback and communication with employees. Formative assessment is any assessment task designed to promote students' learning. These tasks give both teachers and students feedback, so that teaching and learning activities can be altered according to the results.
Formative assessment is different from . Formal and informal assessments have their advantages and disadvantages. Formal assessments are standardized tests that are designed by test specialists.
There are given and scored under a standard condition. Informal assessments are tests designed by teachers for use in their classroom. Standardized tests are a type of formal assessments.