Facing Up to Unpalatable Evidence for the Sake of Our Patients

Mullen, Paul E.

doi:10.1371/journal.pmed.1000112

Cited by 12 publications

(11 citation statements)

References 5 publications

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“…We support previous calls (Mullen 1997, 2009, Choe et al . 2008) for mental health professionals to firstly acknowledge the risk of violence associated with some mental disorders/symptoms, and secondly, to develop effective risk assessment and management strategies aimed at violence prevention .…”

Section: Discussionsupporting

confidence: 92%

“…2004, Vevera et al . 2005, Laajasalo & Häkkänen 2006, Mullen 2006, 2009, Shawyer et al . 2008, Warren et al .…”

Section: Discussionunclassified

“…1999, Hellerstein et al . 2007) and may receive reduced quality of and access to care as a result of violent behaviour (Mullen 2009). This, together with the significant economic, organizational and social costs associated with staff injury (Krug et al .…”

Section: Discussionmentioning

confidence: 99%

“…We support previous calls (Mullen 1997, Choe et al 2008 for mental health professionals to firstly acknowledge the risk of violence associated with some mental disorders/symptoms, and secondly, to develop effective risk assessment and management strategies aimed at violence prevention. There is evidence to suggest that patients involved in interventions to manage violence such as restraint and seclusion suffer considerable trauma (Meyer et al 1999, Hellerstein et al 2007) and may receive reduced quality of and access to care as a result of violent behaviour (Mullen 2009). This, together with the significant economic, organizational and social costs associated with staff injury (Krug et al 2002), should serve as powerful motivators to drive this agenda.…”

Section: Discussionmentioning

confidence: 99%

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Mental health‐related risk factors for violence: using the evidence to guide mental health triage decision making

Sands

Elsom

Gerdtz³

et al. 2011

Psychiatric Ment Health Nurs

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Mental health clinicians working in emergency crisis assessment teams or mental health triage roles are required to make rapid and accurate risk assessments. The assessment of violence risk at triage is particularly pertinent to the early identification and prevention of patient violence, and to enhancing the safety of clinical staff and the general public. To date, the evidence base for mental health triage violence risk assessment has been minimal. This study aimed to address this evidence gap by identifying best available evidence for mental health-related risk factors for patient-initiated violence. We conducted a systematic review based on the National Health and Medical Research Council of Australia's methodology for systematic reviews. A total of 6847 studies were retrieved, of which 326 studies met the study inclusion criteria. Of these studies, 277 met inclusion criteria but failed the quality appraisal process, thus a total of 49 studies were included in the final review. The risk factors that achieved the highest evidence grading were predominantly related to dynamic clinical factors immediately observable in the patient's general appearance, behaviour and speech. These factors included hostility/anger, agitation, thought disturbance, positive symptoms of schizophrenia, suspiciousness and irritability.

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Section: Discussionsupporting

confidence: 92%

“…2004, Vevera et al . 2005, Laajasalo & Häkkänen 2006, Mullen 2006, 2009, Shawyer et al . 2008, Warren et al .…”

Section: Discussionunclassified

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mental health‐related risk factors for violence: using the evidence to guide mental health triage decision making

Sands

Elsom

Gerdtz³

et al. 2011

Psychiatric Ment Health Nurs

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“…Arguably, more important to the discussion regarding the overlap between mental illness and violence are the treatment implications, particularly for adolescents and young people. Adopting an early intervention framework may be critical for reducing, if not preventing, violence and offending among the mentally ill, and may ultimately save lives Mullen, 2009).…”

mentioning

confidence: 99%

Characteristics of Mentally Disordered Youth Referred to a Forensic Satellite Clinic for Violence Risk Assessment: A Case Control Study

Baksheev

Sullivan²,

Fraser

et al. 2014

Psychiatry, Psychology and Law

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There is a lack of appropriate services to manage youth with comorbid mental health problems and violence risks. To address this gap, we implemented a forensic satellite clinic in a youth mental health service. This paper characterises offending histories among 45 young patients referred to the clinic, and compares them with matched clinical controls (n D 45). Levels of prior risk taking and aggression were prominent among referred patients. Forensic cases and controls did not differ on demographic and clinical variables, with the exception of psychiatric inpatient admissions, which were higher among referred patients. Group differences were observed for prior offending variables (e.g., physical aggression), which were significantly higher among referred patients than controls. Findings suggest that referrals were made to the clinic based on challenging and aggressive behaviour rather than specific clinical characteristics. The role of specialist assessment, treatment and management of violence risks in youth mental health services are discussed.

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Early Intervention to Reduce Violence and Offending Outcomes in Young People with Mental Disorders

Fraser

Purcell

Sullivan

2014

Early Intervention in Psychiatry

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Facing Up to Unpalatable Evidence for the Sake of Our Patients

Abstract: Paul Mullen discusses Seena Fazel and colleagues' paper on the association between violent behavior and having been diagnosed with a schizophrenic disorder, and its implications for care of these individuals.

Cited by 12 publications

References 5 publications

Mental health‐related risk factors for violence: using the evidence to guide mental health triage decision making

Mental health‐related risk factors for violence: using the evidence to guide mental health triage decision making

Characteristics of Mentally Disordered Youth Referred to a Forensic Satellite Clinic for Violence Risk Assessment: A Case Control Study

Early Intervention to Reduce Violence and Offending Outcomes in Young People with Mental Disorders

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