Field validity of the HCR-20 in forensic medium security units in Flanders

Structured risk assessment has become a part of routine practice in forensic settings. However, little attention has been paid to the clinical applicability of existing tools. The present research focused on the performance of the Historical Clinical Risk Management-20 (HCR-20) – one of the most commonly used tools for structured professional judgment – in the daily practice of three medium security units in Flanders. Areas under the curve for the prediction of violent recidivism during (N = 168) and after (N = 105) medium security treatment were non-significant. In addition, analyses showed that the HCR-20 was mainly of interest in identifying low-risk individuals. Further research measuring different aspects of predictive validity in applied settings is recommended.Keywords: Risk assessment, structured professional judgment, HCR-20, forensic psychiatry, field validity