Screening for risk of violence using service users’ self‐perceptions: A prospective study from an acute mental health unit

• Published in: International journal of mental health nursing 2018-06, Vol.27 (3), p.1055-1065
• Main Authors: Lockertsen, Øyvind, Procter, Nicolas, Vatnar, Solveig Karin Bø, Færden, Ann, Eriksen, Bjørn Magne S., Roaldset, John Olav, Varvin, Sverre
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Clinical assessment; Efficacy; Feasibility; Female; gender; Gender differences; High risk; Hospitalization; Hospitals, Psychiatric; Humans; Inpatients - psychology; Interdisciplinary aspects; Male; Medical screening; Mental Disorders - psychology; Mental health; mental illnesses; Nursing; Patient participation; Perceptions; Prospective Studies; Psychiatric-mental health nursing; Risk assessment; Risk Assessment - methods; Risk perception; Self Concept; Self report; Violence; Violence - prevention & control; Violence - psychology
• ISSN: 1445-8330; 1447-0349
• DOI: 10.1111/inm.12413

Service users’ self‐perception of risk has rarely been emphasized in violence risk assessments. A recent review pointed to the importance of a multidisciplinary approach, because different perspectives may provide a deeper and improved understanding of risk assessment. The aim of this study was to investigate service users’ perceptions of their own risk of committing violence, using a self‐report risk scale, to determine the feasibility and efficacy of this potential violence risk marker during acute mental health hospitalization. All service users admitted to a psychiatric emergency hospital in Norway during one calendar year were included (N = 512). Nearly 80% self‐reported no risk or low risk; only seven (1.4%) reported moderate risk or high risk. Service users who reported moderate risk, high risk, don't know, or won't answer were more likely to be violent (OR = 4.65, 95% CI = 2.79–7.74) compared with those who reported no risk or low risk. There was a significant gender interaction with higher OR for women on both univariate and multivariate analyses. Although the OR was higher for women, women's violence rate (11.0%) was almost half that of men (21.8%). For women, sensitivity and specificity were 0.55 and 0.88, respectively; corresponding values for men were 0.40 and 0.80. Inclusion of self‐perception of violence risk is the first step towards service users’ collaborative involvement in violence prediction; these results indicate that self‐perception can contribute to violence risk assessments in acute mental health settings. Findings also indicate that there are gender differences in these assessments.