Risk assessment of imminent violence in acute psychiatry: a step towards an extended model

Aggression occurs frequently in mental health care settings, and studies have reported that 17% to 31% of patients admitted to acute psychiatric wards commit violence. Inpatients' fluctuating mental states and behaviour patterns reinforce the need for an assessment instrument to predict potenti...

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Bibliographic Details
Published in:The journal of forensic psychiatry & psychology 2020-01, Vol.31 (1), p.41-63
Main Authors: Lockertsen, Øyvind, Varvin, Sverre, Færden, Ann, Eriksen, Bjørn Magne Sundsbø, Roaldset, John Olav, Procter, Nicholas G., Vatnar, Solveig Karin Bø
Format: Article
Language:English
Subjects:
Acute psychiatry
aggression
Clinical assessment
Evaluation
Health risk assessment
Hospitalization
Inpatient care
Measures
Medical screening
Mental disorders
Mental health care
Mental health services
Mental states
Patient admissions
Patients
Predictions
Psychiatric hospitals
Psychiatry
repeated measurements
Risk assessment
Self report
Short term
Tests
Violence
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Summary:Aggression occurs frequently in mental health care settings, and studies have reported that 17% to 31% of patients admitted to acute psychiatric wards commit violence. Inpatients' fluctuating mental states and behaviour patterns reinforce the need for an assessment instrument to predict potential violence in a timely manner. This naturalistic prospective inpatient study investigated whether an extended short-term risk assessment model that combines (a) short-term risk assessment with the Broset Violence Checklist (BVC), (b) patient's own prediction of violence with the Self-Report Risk Scale (SRS) and (c) single items from the Violence Risk Screening 10 (V-RISK-10) provides better short-term predictive accuracy for violence than the BVC alone. All patients admitted to a psychiatric emergency hospital in Norway during one year were included (N = 508). Stepwise multivariate generalised linear mixed model analyses were conducted. When adjusting for repeated measurements, the results indicated that an extended model for short-term risk assessment, consisting of the BVC, SRS and Item 2 Previous and/or current threats from the V-RISK-10 explained more variance of imminent violence, compared to the BVC alone. Further studies are recommended to investigate whether the extended model provides a clinically better short-term risk prediction of imminent violence, compared to the BVC alone.
ISSN:1478-9949
1478-9957
DOI:10.1080/14789949.2019.1663898