The interrater reliability of violence risk assessment using HCR 20 Version 3 and SAPROF in a sample of Polish forensic psychiatric patients and prison inmates.

OBJECTIVES

The aim of the study was to validate the reliability of the Historical Clinical Risk Management-20 Version 3 (HCR-20 V3) and the Structured Assessment of Protective Factors (SAPROF) assessment tools for use in Polish forensic psychiatry and penitentiary settings. Despite their global popularity and Polish-language adaptations, these methods remain underutilized in Poland.

METHODS

Data were collected with HCR-20 V3 and SAPROF from 401 male subjects, including forensic psychiatric patients and inmates, between 2020 and 2023. Assessments were conducted twice, six months apart, and they were independently analyzed by three trained investigators to calculate interrater reliability using Krippendorff's alpha.

RESULTS

The results demonstrated very good interrater reliability for historical risk assessments across groups. Reliability was slightly lower for clinical and dynamic risk factors, reflecting challenges in evaluating factors without direct contact with subjects. For inmates, limited psychological support and systemic post-release aid influenced the reliability of risk management evaluations. In contrast, external protection assessments were more reliable in inmates than forensic psychiatric patients, whose outcomes depended on uncertain post-release supervision and therapy availability.

CONCLUSIONS

In the study, the importance was highlighted of integrating protective factors into risk assessments and it was confirmed that HCR-20 V3 and SAPROF produce reliable results when used by trained professionals. These findings address concerns among Polish practitioners regarding potential biases in SPJ tools. High interrater reliability of final risk and protection assessments reinforces the potential for broader adoption of these tools in Poland.