Applicability of the DUNDRUM-1 in a forensic Belgium setting
| DOI | https://doi.org/10.1108/JFP-11-2018-0043 |
| Date | 31 January 2019 |
| Pages | 85-94 |
| Published date | 31 January 2019 |
| Author | Petra Habets,Inge Jeandarme,Harry G. Kennedy |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice |
Applicability of the DUNDRUM-1 in a
forensic Belgium setting
Petra Habets, Inge Jeandarme and Harry G. Kennedy
Abstract
Purpose –Criteria to determine in which level of security forensic patients should receive treatment are
currently non-existent in Belgium. Research regarding the assessment of security level is minimal and few
instruments are available. The DUNDRUM toolkit is a structured clinical judgement instrument that can be
used to provide support when determining security level. The purpose of this paper is to investigate the
applicability and validity of the DUNDRUM-1 in Flanders.
Design/methodology/approach –The DUNDRUM-1 was scored for 50 male patients admitted at the
forensic units in the public psychiatric hospital Rekem. Some files were rated by three researchers who were
blind to participants’security status, resulting in 33 double measurements.
Findings –Almost all files (96 per cent) contained enough information to score the DUNDRUM-1.
Average DUNDRUM-1 final judgement scores were concordant with a medium security profile. No difference
was found between the current security levels and the DUNDRUM-1 final judgement scores. Inter-rater
reliability was excellent for the DUNDRUM-1 final judgement scores. On item level, all items had excellent to
good inter-rater reliability with the exception of one item institutional behaviour which had an average
inter-rater reliability.
Practical implications –The DUNDRUM-1 can be a useful tool in Flemish forensic settings. It has good
psychometric properties. More research is needed to investigate the relationship between DUNDRUM-1
scores and security level decisions by the courts.
Originality/value –This is the first study that investigated the applicability of the DUNDRUM-1 in a Belgian
setting, also a relative large number of repeated measurements were available to investigate the inter-rater
reliability of the DUNDRUM-1.
Keywords Reliability, Forensic mental health, Needs assessment, DUNDRUM toolkit, Security level
Paper type Research paper
In Belgium when a person is declared not guilty by reason of insanity, that person will not be
sentenced to prison but ordered to a protection measure for an indefinite period, an internment
measure. A specialised court called the Chamber of the Protection of Society (CPS) is
responsible for the execution of the internment measure. The CPS is responsible for granting
leave and granting conditional or unconditional release, it decides in which setting the internee
will be treated after conditional release and it decides what level of security the patient needs to
undergo treatment. Criteria to determine the level of security are currently non-existent in
Belgium. However, it is the responsibility of the CPSs to refer patients to the level of therapeutic
safety and security that is compatible with their risks and needs. Incorrect assessment of this can
have a serious impact on society, forensic services and the patient.
It is important to distinguish between level of risk and level of security. Instruments to determine
the level of risk of recidivism are abundant in the scientific literature which is in stark contrast to
the amount of literatur e available concerni ng the determinatio n of the level of security.
Risk is defined as the d egree of violent tendencies and the risk of (violent ) recidivism which may
be low, medium or hig h. This risk is usual ly measured by struct ured risk assessme nt
instruments. The level of security, on the other hand, is classified according to structural
(e.g., medium security, an escape-resistant building), procedural (e.g., supervised
access, limited access to money) and relational security characteristics (Kennedy, 2002).
Relational security characteristics are related to quality of care and relate to high, medium or
Received 5 November 2018
Revised 28 January 2019
Accepted 7 February 2019
Petra Habets and
Inge Jeandarme are both
based at Knowledge Centre
Forensic Psychiatric Care,
Public Psychiatric Hospital
Rekem, Rekem, Belgium.
Harry G. Kennedy is based at
Central Mental Hospital,
National Forensic Mental
Health Service, Dublin, Ireland.
DOI 10.1108/JFP-11-2018-0043 VOL. 21 NO. 1 2019, pp. 85-94, © Emerald Publishing Limited, ISSN 2050-8794
j
JOURNAL OF FORENSIC PRACTICE
j
PAG E 85
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