Selecting and Monitoring Living Skills in Forensic Mental Health Care: Cross-Border Validation of the BEST-Index

Background: Assessment of living skills and violence risk in forensic psychiatric patients is a priority for clinicians. Suitably fine-grained instruments are rare.Aim: We cross-validate a norm-based psychometric assessment battery (the Behavioral Status Index [BEST-Index]) against known valid instruments. Method: Parallel cohort studies were undertaken in five European countries. Inpatients (N = 231) from 24 forensic psychiatric clinics were assessed three times, using five instruments measuring living skills, psychological symptoms, aggression, and violence risk. Results: Positive clinical changes were noted in communication and living skills, with little change in violence risk, which was low to medium for 90 percent of patients. Clinical congruence was observed between logically cognate items of cross-validators and the BEST-Index. Discussion: Evidence for the scientific and clinical utility of the BEST-Index as an effective guideline for treatment priorities and outcomes is discussed.