Abstract

At present, there are few validated tools to assist clinicians in assessing absconding risk and formulating viable risk management plans. In this article, we review existing literature on instrument validity and reliability in relation to absconding among patients in forensic care. We examine the predictive validity of a new risk assessment scale for absconding, the Waypoint Elopement Risk Scale-Historical (WERS-H), and assess its incremental utility against a general violence risk assessment instrument (HCR-20^V3). Results from all active inpatients in our service (N = 139) revealed 73 individuals who were responsible for 261 absconding events from 2014 to 2020, representing a similar event frequency from a previous census conducted in 2012, but also reflecting considerable annual fluctuations in rate. Confirming results of earlier studies, the presence of substance use and lengthy durations of forensic supervision emerged as key variables associated with absconding. The WERS-H was found to be a significant predictor of future absconding events (incident rate ratio = 1.21, 95% CI [1.07, 1.38], p = .002) and contributed incrementally over the HCR-20^V3 Historical scale, suggesting that the use of an absconding-specific risk tool may yield better predictive accuracy compared to assessment instruments in the domain of general violence or offending.

摘要

目前，很少有经过验证的工具可以帮助临床医生评估潜逃风险并制定可行的风险管理计划。在这篇文章中，我们回顾了与法医护理患者潜逃相关的工具有效性和可靠性的现有文献。我们检查了新的潜逃风险评估量表 Waypoint Elopement Risk Scale-Historical (WERS-H) 的预测有效性，并评估其相对于一般暴力风险评估工具 (HCR-20 V3) 的增量^效用。我们服务中所有活跃住院患者的结果 ( N = 139) 揭示了 73 人对 2014 年至 2020 年的 261 起潜逃事件负责，这与 2012 年进行的上一次人口普查的事件频率相似，但也反映出每年发生率的相当大的波动。确认早期研究的结果、物质使用的存在和法医监督的持续时间过长成为与潜逃相关的关键变量。WERS-H 被发现是未来潜逃事件的重要预测因子（事故率比率 = 1.21，95% CI [1.07，1.38]，p = .002），并且在 HCR-20 V3 历史量表上的贡献逐渐增加^，表明与一般暴力或犯罪领域的评估工具相比，使用针对潜逃的风险工具可能会产生更好的预测准确性。