Quantitative Outcomes for Shared Assessment and Management in Forensic Mental Health: A Meta-Analysis and Systematic Review.
Mimosa Luigi, Xavier Larochelle, Anne G Crocker
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In 30 seconds
This systematic review and meta-analysis examined quantitative evidence on shared assessment and management among adult forensic mental health inpatients. Fifteen evaluations were included, although only one of three planned meta-analyses could be conducted. Across seven records with paired clinician–user ratings, the random-effects analysis found a significant, large paired standard difference of .95 (95% CI = [.49,1.42]). Clinicians generally rated patients as having more needs and making less progress than patients rated themselves. The review found an evidence gap on whether shared approaches improve care outcomes, including violence or restriction.
Key findings
- Across seven records, clinician–user ratings showed a paired standard difference of .95 (95% CI = [.49,1.42]).
- Clinicians generally rated more needs and less progress than users across assessment tools.
- Quantitative evidence was insufficient to establish effects of shared approaches on violence or restriction.
Why it matters
Differences between clinician and user assessments may be clinically useful to identify divergent views of needs and progress and to prompt collaborative discussion in forensic settings. However, rating differences do not establish that shared assessment improves care outcomes. The review highlights the need for consistent agreement measures and stronger quantitative evaluation of outcomes.
What to keep in mind
Only one of three planned meta-analyses could be conducted, and the authors acknowledge between-study heterogeneity. Evidence on quantitative care outcomes remains limited.