Letter/Observer Forum

Practical Solutions to Violence

At the 2014 APS Annual Convention, four researchers (as reported in the July/August Observer article “Exploring the Psychological Science of Violence”) missed essential components of US violence and how to address it. During the 1970s, as 94% of mentally ill patients were released from psychiatric hospitals, there were fewer psychiatrists to assist them. Simultaneously, jobs — the best diversion from violence for at-risk teens and adults — disappeared for these often unskilled workers.

In Chicago and the rest of Cook County, this challenge was addressed by Mayor Daley with the $78 million US Justice Department “Culture of Calm” program from 2009 to 2012 after I initiated a task force with K. G. Busch, MD. This projected provided jobs, mentors, and anger management targeted to 4,850 at-risk adolescents (Zagar, Grove, & Busch, 2013; Zagar et al., 2013a).

This effort continued with the $50 million Chicago Public Safety Fund in 2013, which provided employment, mentoring, and anger cognitive-skills training targeted to 20,000 at-risk adolescent students (Zagar, 2014). This evidence-based targeting of algorithmically identified students saved 193 lives and $1.4 billion according to a publicly and privately backed empirical assessment (Zagar, 2014).

To target jobs to at-risk teens or adults who are violence-prone, individuals’ risks must be actuarially appraised. I provided published regression-based checklists and sensitive, specific, and inexpensive Internet testing to screen and assess fitness within schools, universities, and workplaces to ensure medical care and treatment (Zagar et al., 2013a; Zagar et al., 2013b).

The efforts of the researchers who spoke at the APS Annual Convention are interesting, but they were driven by outdated literature reviews that should encompass evaluation with treatment. The roots of violence are well known, yet on September 29, 2013, in a Sixty Minutes broadcast, the Cook County Sheriff Thomas J. Dart asserted that 2,500 mentally ill people were housed in the adult jail, arguably the largest “asylum” in the US. The prison houses 10,000 prisoners with little medical attention.

Cook County Board President Toni Preckwinkle, who saved half a billion dollars by moving nonviolent youth and adults to electronic ankle-bracelet surveillance, estimated that 85% to 90% of prisoners were nonviolent (Zagar et al., 2013a). Furthermore, while science like suicide prevention and neuroimaging of the violence-prone is fascinating, poor, at-risk youth lack basic medical, family, school, and work supports to avoid court contacts, poor decision making, lower social functioning, and other specific risks that empirically precede violent behavior.

Actuarial testing and treatment offer a solution to these scientific puzzles of homicide and suicide. For the public, wars are attention grabbing, but since 1776, more US citizens have been murdered than have died on the battlefields. Solving urban violence is critical to the quality of life of the public. The MacArthur Violence Risk Assessment Study resulted in a tool with a receiver operating characteristic (ROC) of .75, which may overidentify for proneness to violence, setting up potential violations of civil rights. It is likely that the Classification of Violence Risk (COVR) will miss 25% of violent offenders, putting others at risk (Monahan, et al. 2000).

Zagar, Busch, Grove, and Hughes (2008), Zagar and Grove (2010), and Zagar (2014) point out the difference between ROC= .75 and AUC=.91 and .99. Currently, the Standard Predictor (Zagar et al., 2014) will achieve the best predictive validity for violence at ROC≥.90. In Chicago, the partial use of an empirical regression or testing approach to find the at-risk in the school population with an equation replicated four times and independently a fifth time by University of Chicago Freakonomics economist-professor Steven Levitt (Chandler, Levitt, & List, 2011) has proven the success of this method in the real world, never before demonstrated.

The aforementioned four researchers’ admirable presentations offer no ready solutions. Given the cost of violence to taxpayers and industry, APS members might be interested in the empirical and real-world successes of the Standard Predictor as a solution to violence. Imagine a world where actuarial testing was used to protect organizations like the airlines, energy, military, nonprofit-religious, personal injury insurance cases, public safety, transportation and port agencies, and workers’ compensation. Picture state and federal governments which release more funds to education and health by moving nonviolent prisoners using actuarial assessment advocated by Paul Meehl 6 decades ago (Meehl, 1954), saving $37 billion yearly (Zagar, 2014).

I testified about these issues before the US House of Representatives Judiciary Subcommittee on Crime Terrorism and Homeland Security on July 24, 2014, sitting between Michigan’s John Conyers and Virginia’s Robert Scott, and US President Obama spoke about them again the next day.

I reviewed the above efforts in Chicago and Cook County and pointed out that the US Department of Defense was losing about $1 billion in recruitment and boot camp training yearly because of a lack of mental health screening, the same point I made by showing actuarial assessment saves lives and expenses for at-risk youth.

My efforts were not without result: The House has a Thompson Bill to Improve Military Mental Health (HR 4305 MEPS ACT) as part of the massive 2015 defense budget. This was a response to two Fort Bragg killing sprees. I spoke to the Suicide Prevention Units of the Veterans Administration and Department of Defense in August and September of 2012 about this same effort. Academic and research psychologists can make a safer world where there is hope.

By using actuarial testing daily in emergency rooms the 15 million at-risk patients that show up at these hospitals can be diagnosed cost effectively and treated with evidence-based, cost-beneficial interventions along with finding work, which diverts persons from jail the best (37%). These approaches would lower both the homicide and the suicide rates by perhaps a thousand with tens of billions in savings (just increasing my efforts in Chicago by ten times), combining the best of academic-research psychology with real-world practical applications for safer communities to raise our families.

-Robert J. Zagar

References

Chandler, D., Levitt, S. D., & List, J. A. (2011). Predicting and preventing shootings among at-risk youths.  American Economic Review, 101, 288–292.

Meehl, P. (1954). Clinical versus statistical prediction. Minneapolis, MN: University of Minnesota Press.

Monahan, J., Steadman, H. J., Applebaum, P. S., Grisso, T., Mulvey, E. P., Roth, L. H. … & Silver, E. (2000). Classification of Violence Risk: Professional manual. Lutz, FL: Psychological Assessment Resources, Incorporated.

Zagar, R. J. (2014). Safeguarding Organizations by Finding the “Outlier” with Internet Sensitive and Specific Recruit and Fitness for Duty Tests, Society of American Military Engineers (SAME) and The Infrastructure Security Partnership (TISP) Website: Denver, Colorado, April 8.

Zagar, R. J., Busch, K. G., Grove, W. M., & Hughes, J. R. (2008). Can violent (re)offense be predicted?  A review of the role of the clinician and use of actuarial tests in light of new data. Psychological Reports, 104, 247–277.

Zagar, R. J., & Grove, W. M. (2010) Violence risk appraisal of  male and female youth, adults, and individuals. Psychological Reports, 107(3), 983–1009.

Zagar, R. J., Grove, W. M., & Busch, K. G. (2013). Delinquency best treatments: How to divert youths from violence while saving lives and detention costs. Behavior Sciences & the Law, 31, 381–396.

Zagar, R. J., Kovach, J. W., Ferrari, T., Grove, W. M., Busch, K. G., Hughes, J. R., & Zagar, A. K. (2013). Applying best treatments by using a regression equation to target violence prone youth: a review, Comprehensive Psychology, 2, 6.

Zagar, R. J., Kovach, J. W., Basile, B. B., Hughes, J. R., Grove, W. M., Busch, K. G. … & Liu, Y (2014). Finding workers, offenders, or students most at-risk for violence: actuarial tests save lives and resources. Psychological Reports, 113, 1–32.

Robert John Zagar PhD MPH, Juvenile Division Circuit Court of Cook County, Chicago, IL.

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