Structured versus unstructured judgment: DUNDRUM-1 compared to court decisions.
BACKGROUND
Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Courts largely rely on the evaluations of the prison psychiatrists and psychologists to form their decision. None of the few available instruments - e.g., the DUNDRUM-1 - is currently used to provide structured clinical judgment when determining security level.


METHOD
DUNDRUM-1 scores were collected for 150 forensic patients. Security levels according to DUNDRUM-1 assessment were compared to security levels as decided by the court.


RESULTS
There was little agreement between DUNDRUM-1 scores and proposals for secure care made by the court. The DUNDRUM-1 predicted eventual admission to a high security setting, but not a medium security setting.


CONCLUSION
The DUNDRUM-1 is an instrument that can help clinicians and judges to make more reliable and transparent decisions regarding secure care. However, further research with regard to practical applicability is needed.
['Jeandarme|Inge|I|', 'Habets|Petra|P|', 'Kennedy|Harry|H|']
D000328:Adult D000368:Aged D057237:Criminals D005555:Forensic Psychiatry D006801:Humans D007298:Insanity Defense D000079243:Involuntary Commitment D007600:Judgment D007603:Jurisprudence D008297:Male D008875:Middle Aged D012189:Retrospective Studies D012637:Security Measures D014754:Violence D055815:Young Adult
DUNDRUM-1 Court decision Security level Forensic psychiatry