Girls and women represent a minority of forensic mental health and prison populations. However, studies worldwide suggest that there has been a steady increase in the number of girls and women being managed by forensic mental health services and correctional agencies over the past two decades. The vast majority of research in the forensic mental health field, however, remains steadfastly focused on male populations. As such, there are growing concerns about whether the theoretical knowledge we have on male offenders is sufficiently valid and useful for female offenders. There remain substantial gaps in knowledge and debate regarding the importance of gender differences, for instance, in developmental pathways to offending and in violence risk factors and assessment. There is a similar paucity of knowledge on the efficacy of treatment in female offenders and a need for treatment programs that are specifically responsive to the needs and issues of these girls and women. These special issues of the International Journal of Forensic Mental Health dedicated to gender issues in the forensic field marks a substantial effort to enlarge the empirical and theoretical knowledge on (violent) offending, assessment, and treatment in girls and women. In this introduction article, we aim to highlight the relevance of studying gender differences in the forensic field and to provide a brief overview of important gender issues in developmental pathways to offending, gender differences and similarities in the nature of offending, assessment and treatment in forensic mental health care and the criminal justice system. Finally, we provide recommendations for practitioners, researchers, and policymakers to move forward on this topic in the forensic field.

Gender differences were explored in PCL-R codings and the manifestation of psychopathy in 197 female and 197 male patients admitted between 1984 and 2013 to one of four Dutch forensic psychiatric hospitals. Four groups were compared with respect to criminological characteristics, historical violence risk factors and psychiatric characteristics including incidents during treatment. The lowered PCL-R cut-off score of 23 as applied in the Female Additional Manual (FAM; de Vogel, de Vries Robbé, van Kalmthout, & Place, 2012 de Vogel, V. , de Vries Robbé, M. , van Kalmthout, W. , & Place, C. (2012). Female Additional Manual (FAM). Additional guidelines to the HCR-20 for assessing risk for violence in women (English version). Utrecht, The Netherlands : Van der Hoeven Kliniek. [Google Scholar] ) was used to define women with psychopathy. The four groups were: (1) women without psychopathy (PCL-R < 23), (2) women with psychopathy (PCL-R ≥ 23), (3) men without psychopathy (PCL-R < 30), and (4) men with psychopathy (PCL-R ≥ 30). Overall, it was found that women and men with psychopathy show multiple similarities in their personal and criminal histories, but there were also several gender differences. Women with psychopathy compared to men with psychopathy committed more fraud, offended more often out of relational frustration, were more often diagnosed with the Borderline Personality Disorder, and showed less physical violence, but more manipulative and self-destructive behavior during treatment. Overall, women obtained lower scores on the PCL-R than men. Predictive validity of the PCL-R for physical violence during treatment was good for men and moderate for women. When verbal violence was included in the definition of violence, the predictive validity of the PCL-R was good for both the female and male sample. Implications of this study for forensic practice are discussed and several directions for future research are provided.

Most violence risk assessment tools have been validated predominantly in males. In this multicenter study, the Historical, Clinical, Risk Management–20 (HCR-20), Historical, Clinical, Risk Management–20 Version 3 (HCR-20^V3), Female Additional Manual (FAM), Short-Term Assessment of Risk and Treatability (START), Structured Assessment of Protective Factors for violence risk (SAPROF), and Psychopathy Checklist–Revised (PCL-R) were coded on file information of 78 female forensic psychiatric patients discharged between 1993 and 2012 with a mean follow-up period of 11.8 years from one of four Dutch forensic psychiatric hospitals. Notable was the high rate of mortality (17.9%) and readmission to psychiatric settings (11.5%) after discharge. Official reconviction data could be retrieved from the Ministry of Justice and Security for 71 women. Twenty-four women (33.8%) were reconvicted after discharge, including 13 for violent offenses (18.3%). Overall, predictive validity was moderate for all types of recidivism, but low for violence. The START Vulnerability scores, HCR-20^V3, and FAM showed the highest predictive accuracy for all recidivism. With respect to violent recidivism, only the START Vulnerability scores and the Clinical scale of the HCR-20^V3 demonstrated significant predictive accuracy.

The past two decades, a disproportionate growth of females entering the criminal justice system and forensic mental health services has been observed worldwide. However, there is a lack of knowledge on the background of women who are convicted for violent offenses. What is their criminal history, what are their motives for offending and in which way do they differ from men convicted for violent offenses? In this study, criminal histories and the offenses for which they were admitted to forensic care were analysed of 218 women and 218 men who have been treated between 1984 and 2014 with a mandatory treatment order in one of four Dutch forensic psychiatric settings admitting both men and women. It is concluded that there are important differences in violent offending between male and female patients. Most importantly, female violence was more often directed towards their close environment, like their children, and driven by relational frustration. Furthermore, female patients received lower punishments compared to male patients and were more often considered to be diminished accountable for their offenses due to a mental illness.

There are few studies of stalking recidivism and none examining risk factors for recidivistic stalking of the same victim versus a different victim. Data from 70 clients of Dutch community forensic mental health clinics was used to investigate the prevalence of stalking recidivism, risk factors, and any potential protective effect of psychological treatment. Over 50% were again reported to police for stalking over two years, including 21% who stalked a new victim. No risk factors were significantly related to future stalking and psychological treatment was unrelated to recidivism. Possible explanations for these findings and directions for future research are discussed.

The HCR-20^V3 is a violence risk assessment tool that is widely used in forensic clinical practice for risk management planning. The predictive value of the tool, when used in court for legal decision-making, is not yet intensively been studied and questions about legal admissibility may arise. This article aims to provide legal and mental health practitioners with an overview of the strengths and weaknesses of the HCR-20^V3 when applied in legal settings. The HCR-20^V3 is described and discussed with respect to its psychometric properties for different groups and settings. Issues involving legal admissibility and potential biases when conducting violence risk assessments with the HCR-20^V3 are outlined. To explore legal admissibility challenges with respect to the HCR-20^V3, we searched case law databases since 2013 from Australia, Canada, Ireland, the Netherlands, New Zealand, the UK, and the USA. In total, we found 546 cases referring to the HCR-20/HCR-20^V3. In these cases, the tool was rarely challenged (4.03%), and when challenged, it never resulted in a court decision that the risk assessment was inadmissible. Finally, we provide recommendations for legal practitioners for the cross-examination of risk assessments and recommendations for mental health professionals who conduct risk assessments and report to the court. We conclude with suggestions for future research with the HCR-20^V3 to strengthen the evidence base for use of the instrument in legal contexts.