Controversial issues of predicting the risk of public danger with the use of the HCR-20 (assessing risk for violence/version 2)

The article discusses the issues of use of technique HCR-20 (Assessing Risk for Violence/ Version 2) for assessment of dangerous behaviour risk in psychiatric patients when deciding whether to cancel or continue compulsory treatment. The results of examination of patients suffering from serious mental disorder in relation to whom compulsory measures of a medical nature in a psychiatric hospital of specialized type were executed. According to the authors, the bases of predicting the likelihood of committing dangerous actions in mentally ill persons in this clinical situation are clinical-psychopathological examination and observation. Creation of appropriate complex of professionals trained in the field of psychiatry with expertise in the carrying out the compulsory treatment and medical psychologists trained in the preparation of Commission opinions for subsequent consideration and decision of a question on cancellation of compulsory medical measures by the courts is purposeful. The technique HCR-20 may be considered as an additional method of assessing the risk of violence. The use of the HCR-20 structured procedure of risk assessment of dangerous behaviour contributes to a more detailed analysis of anamnestic data and objective factors of risk management that are needed when deciding on the extension or cancellation of forced measures of medical character. Its application requires a balanced approach of domestic psychiatry, as this technique is aimed at determining the risk of violence and does not involve prediction of the likelihood of committing other offensive acts.