External validity and anchoring heuristics: Application of DUNDRUM-1 to secure service gatekeeping in South Wales

Daniel Lawrence, Tracey Lee Davies, Ruth Bagshaw, Paul Hewlett, Pamela Taylor, Andrew Watt*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Aims and method Structured clinical judgement tools provide scope for the standardisation of forensic service gatekeeping and also allow identification of heuristics in this decision process. The DUNDRUM-1 triage tool was completed retrospectively for 121 first-time referrals to forensic services in South Wales. Fifty were admitted to medium security, 49 to low security and 22 remained in open conditions. Results DUNDRUM-1 total scores differed appropriately between different levels of security. However, regression revealed heuristic anchoring on the ‘legal process’ and ‘immediacy of risk due to mental disorder’ items. Clinical implications Patient placement was broadly aligned with DUNDRUM-1 recommendations. However, not all triage items informed gatekeeping decisions. It remains to be seen whether decisions anchored in this way are effective. Declaration of interest Dr Mark Freestone gave permission for AUC values from Freestone et al. (2015) to be presented here for comparison.

Original languageEnglish
Pages (from-to)10-18
Number of pages9
JournalBJPsych Bulletin
Volume42
Issue number1
DOIs
Publication statusPublished - 30 Jan 2018

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