This paper identifies the factors currently considered by Australian mental health professionals in assessing a person's risk for violent behavior and discusses the use of risk assessment in sentencing and preventive detention, as well as the ethical issue of breaching confidentiality in revealing an individual's mental health records in the public interest.
Currently, risk assessment involves the consideration of risk factors, harm, and likelihood. It combines both clinical and actuarial approaches to arrive at a "structural clinical judgment." A number of risk-predictor variables have been identified. They include past violence, pre-existing vulnerabilities, social and interpersonal factors, mental illness, substance abuse, state of mind, situational triggers, and personality constructs. There is some degree of consensus that well-trained clinicians should be able to predict a patient's short-term potential for violence by using assessment techniques analogous to the short-term prediction of suicide risk. Although there are many areas of Australian law in which courts rely on risk assessment by mental health professionals, notably in the areas of sentencing and preventive detention, Australian case-law suggests the courts will be cautious in basing preventive detention on predictions of future behavior. Regarding the ethical issue of confidentiality in medical records, the developing common law in England, New Zealand, and Canada regarding the public-interest exception to confidentiality has provided some guidelines in the forensic setting that may also be appropriate in the therapeutic context. 44 references
Australian Institute of Criminology
GPO Box 2944, Canberra ACT, 2601 Australia, Australia
From Trends & Issues in Crime and Criminal Justice No. 281, July 2004; downloaded December 13, 2004.