The right patient on the right bed: historical risk profiles of two-year post-discharge recidivists, non-recidivists and long-stay patients at the start of forensic treatment

This study examined whether 12 Historical factors of the risk assessment tool Historical Clinical Future – Revised (HKT-R) and the Clinical factor K12 ‘Violation of terms and agreements’ identified during the Legal observation stage, could enhance our understanding of which patients are suitable to initiate treatment in a forensic high – or medium-security clinic. Group differences in Historical factors were examined among three groups: 40 two year post-discharged recidivists, 337 non-recidivists, and 59 long stay patients. Additionally, Historical HKT-R Spider reference profiles were developed to visually represent these potential differences. Lastly, it was examined whether group membership moderated the relationship between the Historical domain score and the K12 score. Results showed that the three groups differed in scores on 11 out of the 12 Historical factors. Recidivists scored the highest on all Historical factors except ‘Treatment history’ in which long-stay patients scored the highest. Group membership did not influence the association between the Historical domain and K12 score. We recommend that Legal observation researchers consider treatment history and incorporate this information when providing placement advice. The HKT-R Spider can serve as an additional tool to determine whether a patient’s treatment should start in a high – or medium-security clinic.