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DUNDRUM Toolkit — MRCPsych Paper B MCQ

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HardForensic PsychiatryDUNDRUM ToolkitMRCPsych Paper B

A forensic mental health service uses the four instruments in the DUNDRUM toolkit to support referral, admission and progression decisions. Which mapping of the instruments to their principal assessment domains is correct?

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Correct answer: B — DUNDRUM-1: therapeutic security need; DUNDRUM-2: admission urgency; DUNDRUM-3: programme completion; DUNDRUM-4: recovery

DUNDRUM-1 supports triage to the appropriate level of therapeutic security, whereas DUNDRUM-2 assesses the urgency or priority of admission from a waiting list. Following admission, DUNDRUM-3 assesses completion of relevant therapeutic programmes and DUNDRUM-4 assesses recovery relevant to progression through the secure-care pathway. Therefore, B gives the correct sequence. A reverses the two referral-stage instruments, while E reverses the two progression instruments. C and D incorrectly assign admission and treatment domains to the wrong scales. The toolkit informs structured professional judgement about placement, prioritisation and progression; it is not simply a violence-risk instrument, although risk information may contribute to its ratings.

Reference: Flynn G, O'Neill C, Kennedy HG. DUNDRUM-2: Prospective validation of a structured professional judgment instrument assessing priority for admission from the waiting list for a forensic mental health hospital. BMC Research Notes. 2011;4:230. https://pubmed.ncbi.nlm.nih.gov/21410967/