Our experts are experienced in both mental and physical health care in secure and custodial settings.
We can provide experts who have direct experience of working in prisons and other criminal justice environments. We have experience of preparing reports in prison law proceedings such as judicial reviews of decisions taken in the psychiatric management of mentally disordered prisoners, the medical treatment of prisoners, claims of discrimination and personal injury claims in prisoners who have been the victim of an assault.
What issues do our experts typically address?
Our psychologist and psychiatrist expert witnesses are regularly instructed to provide
- Opinions to inform a prisoner’s suitability for release
- Assessments of Indeterminate Prisoners for Public Protection (IPP)
- Capacity assessments
- Mental health and personality disorder assessments
- Neuropsychological assessments
- Opinions for prison category reviews
- Recommendations and guidance for rehabilitation
- Recommendations for parole
- Recommendations for therapeutic and risk reduction interventions
- Risk assessments for reoffending
- Sex offender risk assessments
Other experts, including our GPs, dentists, neurologists, and prison nurses may be instructed to provide evidence to inform the delivery of healthcare in prison settings, to review plans for transfer to enable the effective treatment of physical disorder, and to comment upon unmet treatment needs. Solicitors representing serving prisoners may also seek to pursue civil claims for personal injury and clinical negligence within the prison estate. Our experts can comment upon the provision and standards of care within prison settings to inform such proceedings. Our experts take instructions both from claimants and defendants. Our independent social workers are instructed to provide adult social care assessments to inform placement and resettlement.
Risk assessments for prisoners
Approaches to risk assessment differ from professional to professional. The way in which a probation officer will analyse risk of reoffending is very different to the approach used by a clinician working in forensic settings. Broadly, there are three main approaches to risk assessment, which include:
- unstructured clinical judgement
- actuarial risk assessment
- structured professional judgement
Unstructured clinical judgement
Most clinicians use unstructured clinical judgement on a daily basis. Unstructured clinical judgement refers to the practice of forming opinions about risk based on one’s knowledge of risk factors and the individual concerned. The term “unstructured” does not mean that the risk assessment is invalid, but it does run the risk of missing important information in a risk formulation. However, in daily practice, it has good application because the approach is flexible, time efficient and where a clinician knows a patient well, the approach is usually person centred.
Actuarial risk assessment
Another approach to risk assessment is actuarial risk assessment. Examples of actuarial risk assessment may be found in probation assessment tools. Actuarial risk assessment is used in other settings such as the insurance and banking sectors. In actuarial risk assessment, estimates of risk are informed by the statistical relationship between predictors and outcomes. The reliance on statistical relationships means that the outcome estimates are often rigid and inflexible. Further, the risk estimates fail to provide any narrative between the predictor variable and the outcome variable.
Some actuarial tools combine actuarial relationships as well as risk factors which require clinical judgement. One example of such a tool is the Violence Risk Appraisal Guide (VRAG). However, even in this example, the outcome is actuarial because it is formed from statistical relationships. But this approach gives greater reliability than unstructured clinical judgment alone.
Structured professional judgement
Structured professional judgement on the other hand involves clinical judgement of defined risk variables. There are many examples of structured risk assessments including:
- Historical, Clinical and Risk Management Scales (HCR-20) for violence
- Risk for Sexual Violence Protocol (RSVP)
- Short Term Assessment of Risk and Treatability (START) for multiple risk domains
When a clinician uses a structured professional judgement approach, background information is used to decide on the presence of defined risk factors, which are derived from the research literature.
Most structured professional judgement tools give consideration to historical, or static risk factors, as well as dynamic risk factors. The relevance of each factor is rated to inform future risk. Structured professional judgement tools do not rely solely on determining the presence or absence of defined risk factors, they require clinicians to formulate a narrative to explain the relationship between risk factors and risk outcome. This approach allows for risk to be considered for different scenarios. It also allows clinicians to communicate what interventions may reduce the impact of dynamic risk factors. Whilst the risk estimates are not statistically informed, the risk may still be summarised as low, medium, or high, to guide the writing of a risk management plan.
When expert evidence is requested for the Parole Board, sometimes another opinion is being sought to challenge the opinions and recommendations of another professional. It is not uncommon for us to receive instructions for forensics psychologists to conduct their own risk assessment where there are concerns about the opinions and recommendations which are being formed by the prison forensic psychologist. Being able to demonstrate risk assessment approach and risk formulation in a coherent and standardised way is important in maintaining objectivity and to ensure the integrity of the evidence which is being provided to the Parole Board.
Looking for expert parole board & prison law reporting?
If you are looking for an expert witness, please call us on 01865 587865 or email us at firstname.lastname@example.org to see how we may be able to help you.