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Implementation of the Short-Term Assessment of Risk and Treatability over two phases

Authors Kroppan E, Nonstad K, Iversen RB, Søndenaa E

Received 30 January 2017

Accepted for publication 1 June 2017

Published 16 August 2017 Volume 2017:10 Pages 321—326

DOI https://doi.org/10.2147/JMDH.S133514

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Erik Kroppan,1 Kåre Nonstad,1 Runar Busch Iversen,1 Erik Søndenaa1,2

1Department Brøset, St. Olavs Hospital, 2Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway


Background: Over the last decade, the Short-Term Assessment of Risk and Treatability (START) has provided a strong evidence base to predict a range of problem behaviors. The implementation of START and adaptation of the services to the use of START have so far been sparsely described in the literature. The purpose of this study was to describe the continuation and the interdisciplinarity of risk assessments through the two phases.
Methods: Over a period of 10 years, the forensic mental health services at Brøset has implemented START in two phases: initially with implementing the instrument (2005–2009) and secondarily by customizing the instrument to everyday treatment and planning (since 2009). This implementation was based on data from 887 START assessments for 181 patients over a decade (2005–2015).
Results: The results showed that the number of START assessments has been stable throughout the past 10 years and the interval between the ratings has decreased significantly (p<0.05). The involvement by diversity of professionals has increased significantly over the two implementation phases.
Conclusion: This study also addressed the continuity and organization of the implementation process and presented an overview of how START has been widespread in the service through treatment. The results showed an increased multidisciplinary participation and a continuing rate of assessments as the implementation progressed from assessment to a combined assessment–treatment phase.

Keywords: violence risk assessment, treatment planning, mental health, multidisciplinary healthcare

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