Treatment programmes and care pathways for mentally disordered offenders vary substantially across Europe. This is partially due to differences in legal frameworks, policies, and resources in the different European countries. One consequence of these differences is that research to help understand the nature of the association between violence and Severe Mental Disorders (SMDs) has been inconsistent. If we could better understand the factors that increase the risk of violence in specific diagnostic groups then we would be in a better position to design and deliver more accurate means of assessing that risk, and more effective treatments to reduce that risk thereby improving the quality of forensic psychiatric care for patients across Europe.
A variety of methodological challenges have blighted past work and need to be addressed in future project in this field. Only a few studies have focused on the multi-dimensional evaluation of risk and protective factors for violence, including individual, environmental, and situational factors. It has also often been difficult to quantify a patient’s mental status at the time of any violent act. There has also been a lack of a clear common definition of violence and standardization of assessment tools, an inability to fully appreciate the links between mental disorders, comorbidities and violence, heterogeneity of key diagnostic groups, and the use of small samples and thus underpowered studies.
The project aims to assess pathways for forensic psychiatric care in different European countries (currently rather uneven), to identify risk factors for violence and self-harm in people with Schizophrenia Spectrum Disorders (SSDs), to evaluate tools which can predict the risk of violence and self-harm and finally, to assess effective treatments for people with SSDs in forensic services