Police Psychology | How Do We Find and Divert Violence Before It Happens?

Posted: June 21, 2016 in Tests
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Police Psychology | How Do We Find and Divert Violence Before It Happens?

Robert John Zagar PhD MPH and James Garbarino PhD

Homicide, suicide or mass murder, are two sides of a coin. Violence is either directed at others or at oneself. So how do we find violence?

Background checks miss violence 75% of the time. For interviews and judgment the figure is 54%, unstructured physical and psychiatric, 51%, and conventional ways combined miss 61% of violence. How can violencethis be if background checks miss 75%, interviews miss only 54%, or exams 51%?

When the current approaches are summed into an average, the combined approach is less than any one single approach. One would be better off tossing a coin than using these conventional ways. Yet 95% of the professionals persist in “doing the same thing over and over again and expecting different results.” Einstein defined this as insanity.

This fixation with ineffective approaches is costly.  In the United States, work productivity losses due to violence range from $1,000,000 – $5,000,000 per victim, whether it’s homicide, suicide or mass murder.

Also, violence is tied up with mental illness, substance abuse and deceptive self-presentation; 20% of homicidal have psychiatric disorders; 90% of suicidal have severe mental illness; and 59% of mass murderers have mental illness. Most people attempt to cloak or to hide the true nature of their dangerous thoughts and feelings. This leads to deception in presenting oneself to others.

So how does one find someone at-risk for violence? How does one divert someone at-risk for violence? What does unidentified and treated violence cost? And, why is all of this important to you?

When one wishes to find out whether you have diabetes, the physician orders a blood test to have the serum glucose level. If you have hypertension, one measures blood pressure. So why should we not employ the same strategy with violence, and co-occurring mental illness, substance abuse and deception? The easiest, most convenient, sensitive and specific method to determine these is with internet based tests.

Predictive algorithms using internet tests are actually no different than bankers using financial equations to predict the return on the investment of money. However, unlike the conventional approaches that continue to dominate the field, internet-based tests shield the analysis from bias introduced by knowing the age, appearance, education, ethnicity, gender, race, religion, or socioeconomic status (SES) of the person being examined. A lawyer cannot cross examine a computer algorithm about the decision-making test report that is generated with internet-based computer.

Furthermore, a computer equation is consistent with policies and laws that prohibit discrimination and forbid subjectivity. Internet-based tests are consonant with the objective application of the evidence-based, peer-reviewed, scientific facts. While current ways miss 61% of those at-risk for violence, the Standard Predictor equation to find violence that is built into the internet tests has at hit rate of 97%.   The Standard Predictor equation is a set of descriptors that predict whether someone has the potential for abuse and violence.  How does one divert someone at-risk for violence? Researchers have demonstrated that there are three ways to divert someone at-risk for violence are jobs, anger management and mentors.  Jobs divert a person at-risk for violence 37% of the time, while anger management accounts for an additional 25% of the variance, and mentoring another 25%, totaling the three results in 87% of the variance.  

From 2009-2015, a Chicago field test used the Standard Predictor equation to find teens most at-risk for violence, and then applied these three preventive diversions. The result was 324 fewer homicides in the experimental group, saving $2,089,848,548 (with a return on investment of $6.42 for every dollar spent). By the way, when the current, popularly used, random assignment of evidence based diversions were used instead of targeting the most at-risk for violence, the return on investment was $0.57 or a loss of $0.43 for every dollar spent.

So the lesson to be learned is not only using the Standard Predictor equation to “target” the most at-risk for violence, but also applying the best evidence-based diversions to the most at-risk, and not giving the jobs, mentors and anger management to those in need.

How does internet testing and diversions from violence work in the real world of practice? Whether in an emergency room, psychiatric clinic, human resource or employee assistance program, court or jail intake, or a private office, one has to begin with a convenient, inexpensive, sensitive and specific internet test. Tests are objective and nondiscriminatory and help to find out what is the challenge.

Is it violence? What kind of violence is it? Is mental illness involved? Which mental illness? Is substance abuse also present? Which substance abuse? Is the person deceptive? What kind of deception? Everyone lies, so how deceptive is this person?

Only when these questions are answered in a reliable and a valid way with a sensitive and specific tool, can one then address the next challenge or issue at hand and begin the diversion from violence.

Another important issue is stress. There are three kinds of stress. Type I stress is a single incident like an accident, witnessing a murder, or some other one-time event. Type II stress is multiple occurrences. This might be domestic violence or parental or caretaker physical or sexual abuse, workplace harassment, persistent cyberbullying, or some kind of series of stressors over time. Type III stress is many events before the age of four and clearly antecedent to the development of the human brain’s capacity to accommodate to stress. This kind of stress often results in dissociative disorders, extreme mental confusion, memory failure to recall the stress, serious mental illness, and other symptoms co-occurring with violence.

When one knows whether there is violence prone behavior present, mental illness, substance abuse, deception, and the type of stress the person has, then one can begin to plan the evidence based diversion.

So let’s look at some examples of violence and how internet tests can help focus the treatment on the specific challenge or issue. A depressed commercial pilot crashes a planeload of passengers and crew. In this case the airline human resource department (as part of the annual physical exam) can employ internet tests to determine if the pilot has issues and then treat the depression with medication, monitoring medication compliance and adding cognitive behavior therapy to change the thinking of the pilot before a costly liability.

Newly released from jail, a deranged person goes on a killing spree. Had the jail employed internet tests, the psychiatrist would have a diagnosis, the most effective medication, and the evidence based treatments to prevent a tragedy before discharge. Next there is coordination of post-prison services and transition to the community. 

With constant battlefield nightmares, a veteran suffering from post-traumatic stress disorder (PTSD) drives a pickup truck into an oak tree. With internet-based tests that incorporates the Standard Predictor equation, the commander could know before intake and basic training, if the potential service person has the capacity to serve in the military.  Post battlefield, the commander could use internet tests to identify those suffering from stress and order them to see the medical unit staff, receive medication and a 2-3 week leave to allow the person to regroup.  At discharge the commander could use internet tests to coordinate the transition to civilian life. Thus internet tests would help lower the 3 daily military and 22 daily suicides among U.S. military veterans.

A young man kills another while high on drugs. Convicted of homicide he spends decades in jail. Because of the senior author’s book, the U.S. Supreme Court decides in Miller v Alabama, Graham v Florida that it’s unconstitutional to sentence for life without parole a juvenile whose brain was not fully developed to allow rationale decision making. So after taking the internet tests, the imprisoned male without mental illness or substance abuse and at low risk for violence, it eventually released to a transition program.

Using internet-based tests that incorporate the Standard Predictor equation can provide the data needed to use the data needed to apply diversions that are cost beneficial and cost effective. The good news is that one can predict and prevent violence, mental illness and substance abuse, and in doing so will make our communities safer now and for future generations. As already mentioned US violence costs millions of dollars in lost work productivity per victim. Why is violence important to the reader? Violence can occur at any time and in any place and to any person. The reader might be the next victim.

 

Site Editor:  Gary S. Aumiller, Ph.D. ABPP

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Comments
  1. Bryant says:

    http://www.ccsenet.org/journal/index.php/res/article/download/57634/3074

    Is this the correct research article that corresponds to this article about Internet Tests and a Standard Predictor?

  2. Tests for predicting violence are indeed weak eg Hare, etc.
    Yet without references I do not know what the authors are referring
    to when they make note of internet tests. There is promising research
    eg with rapid use of beta blockers following trauma, yet again the
    authors are vague when they refer to post-battlefield medication.
    Finally, having worked with airline pilots, they are extremely reluctant
    to come forward to human resources or EAP due to fear of being
    grounded and are not required to take ‘internet tests’ as part of routine
    medical assessments, nor will many disclose intake of psych meds.

    • Gary Aumiller says:

      I don’t really know the authors or their research. They have published a ton though in peer reviewed journals and in books. I plan on looking through some of their stuff when I get some free time. I might suggest the readers do too. We may all get introduced to new ideas that could change the profession.

  3. mkgrop2015 says:

    Thank you for this article. It would be ideal if there was a reference section so we could properly cite; the information is invaluable. We have used a risk assessment tool (MASTLE) that accurately predicts recidivism and failure to appear. It’s available via the NLC, NYSAP or IACP. By using this tool, we have been able to divert youths away from the criminal justice system and into intervention methodologies that include mentoring, mental health screening, and substance abuse counseling. The goal is to make jail a place solely for the dangerous. For every juvenile we divert into an assistance program (Versus incarceration) we are making a genuine difference in their lives and the lives of their families.
    Michael Gropman Ed.D

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