Modifiable risk factors for inpatient violence in psychiatric hospital: prospective study and prediction model

Fazel, Seena; Toynbee, Mark; Ryland, Howard; Vazquez-Montes, M; Al-Taiar, H.; Wolf, Achim; Aziz, Omar; Khosla, Vivek; Gulati, G. Mitu; Fanshawe, Thomas R

doi:10.1017/s0033291721002063

Cited by 7 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this sample, violence was more common among women. Many studies have shown that male sex is a risk factor for violence in the general population, but often not among people with serious mental illnesses (Brucato et al, 2019 ; Rolin et al, 2018 , 2021 ; Steadman et al, 1998 ) and some studies have shown higher rates of violence among women with mental illnesses (Fazel et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Utility of Different Approaches to Violence Risk Assessment for Young Adults Receiving Treatment for Early Psychosis

Rolin

Scodes²,

Dambreville³

et al. 2022

Community Ment Health J

View full text Add to dashboard Cite

This pilot study examined violence risk assessment among a sample of young adults receiving treatment for early psychosis. In this study, thirty participants were assessed for violence risk at baseline. Participants completed follow-up assessments at 3, 6, 9 and 12 months to ascertain prevalence of violent behavior. Individuals were on average 24.1 years old (SD = 3.3 years) and predominantly male (n = 24, 80%). In this sample , six people (20%) reported engaging in violence during the study period. Individuals who engaged in violence had higher levels of negative urgency (t(28) = 2.21, p = 0.035) This study sought to establish the feasibility, acceptability, and clinical utility of violence risk assessment for clients in treatment for early psychosis. Overall, this study found that most individuals with early psychosis in this study (who are in treatment) were not at risk of violence. Findings suggest that violent behavior among young adults with early psychosis is associated with increased negative urgency. Supplementary Information The online version contains supplementary material available at 10.1007/s10597-021-00922-6.

show abstract

Section: Discussionmentioning

confidence: 99%

Feasibility and Utility of Different Approaches to Violence Risk Assessment for Young Adults Receiving Treatment for Early Psychosis

Rolin

Scodes²,

Dambreville³

et al. 2022

Community Ment Health J

View full text Add to dashboard Cite

show abstract

“…However, one risk factor that has not been identified in qualitative work but reported in the current study is ‘recency of violence post-sentence’. Some of these clinical factors are contained in other risk assessment tools, such as FoxWeb [ 26 ] which is based around 10 modifiable factors, and has been recently validated [ 27 ]. As with FoVOx, FoxWeb is quick to complete, includes predictors that are reliably coded, and requires little training.…”

Section: Discussionmentioning

confidence: 99%

Integrating static and modifiable risk factors in violence risk assessment for forensic psychiatric patients: a feasibility study of FoVOx

Forsman

Cornish

Fazel

2022

Nordic Journal of Psychiatry

Self Cite

View full text Add to dashboard Cite

Introduction Risk assessment is integral to forensic psychiatry. Previous work has highlighted the benefits of using scalable and evidence-based actuarial risk tools developed within forensic populations, such as the online Forensic Psychiatry and Violence Oxford (FoVOx) violence risk assessment tool. We examined the feasibility of using FoVOx in a Swedish forensic cohort and tested whether adding modifiable (dynamic) factors would increase its useability to clinicians. Methods We completed FoVOx assessments on all patients discharged from forensic psychiatric hospitals in Stockholm County, Sweden, between 2012 and 2017 and investigated recidivism rates. In addition, interviews were conducted with the clinicians responsible for each patient on the perceived accuracy, usefulness, and impact of FoVOx, which was examined using thematic analysis. Results Ninety-five discharges from forensic psychiatric hospitals were followed up. The median FoVOx score was a 7% likelihood of violent reoffending in two years after discharge. Six discharged patients (6%) were confirmed as violent recidivists using official records with a similar distribution of FoVOx risk categories as the rest of the sample. FoVOx was considered accurate by clinicians in more than half of cases, who suggested that modifiable risk factors could be added to increase acceptability. All clinicians thought that FoVOx was useful, and in 20% of discharges, it would have materially altered patient care. Overall, FoVOx was thought to impact decision-making and risk management, was practical to use, and could be completed without reference to written case material. Conclusion Completing FoVOx in forensic psychiatric hospitals can complement current approaches to clinical decision-making on violence risk assessment and management.

show abstract

“…These risk factors can be justified as they provide key targets for clinical intervention, from which people at increased risk could benefit ( 46 ). Additional research on novel approaches to risk assessment is required to incorporate more detailed monitoring of fluctuations in symptoms and dynamic risk factors, although this will likely improve needs management rather than risk prediction ( 59 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Risk of Suicide and Violence in Severe Mental Illness: A Feasibility Study of Two Risk Assessment Tools (OxMIS and OxMIV) in General Psychiatric Settings

Beaudry

Canal‐Rivero

Ou³

et al. 2022

Front. Psychiatry

Self Cite

View full text Add to dashboard Cite

BackgroundTwo OxRisk risk assessment tools, the Oxford Mental Illness and Suicide (OxMIS) and the Oxford Mental Illness and Violence (OxMIV), were developed and validated using national linked registries in Sweden, to assess suicide and violence risk in individuals with severe mental illness (schizophrenia-spectrum disorders and bipolar disorders). In this study, we aim to examine the feasibility and acceptability of the tools in three different clinical services.MethodWe employed a two-step mixed-methods approach, by combining quantitative analyses of risk scores of 147 individual patients, and thematic analyses of qualitative data. First, 38 clinicians were asked to use OxMIS and OxMIV when conducting their routine risk assessments in patients with severe mental illness. The risk scores for each patient (which provide a probability of the outcome over 12 months) were then compared to the unstructured clinical risk assessment made by the treating clinician. Second, we carried out semi-structured interviews with the clinicians on the acceptability and utility of the tools. Thematic analysis was conducted on the qualitative data to identify common themes, in terms of the utility, accuracy, and acceptability of the tools. The investigations were undertaken in three general adult psychiatric clinics located in the cities of Barcelona and Sevilla (Spain), and Changsha (China).ResultsMedian risk probabilities over 12 months for OxMIS were 1.0% in the Spanish patient sample and 1.9% in the Chinese sample. For OxMIV, they were 0.7% (Spanish) and 0.8% (Chinese). In the thematic analysis, clinicians described the tools as easy to use, and thought that the risk score improved risk management. Potential additions to predictors were suggested, including family history and the patient's support network. Concordance rates of risk estimates between the tools and clinicians was high for violence (94.4%; 68/72) and moderate for suicide (50.0%; 36/72).ConclusionBoth OxMIS and OxMIV are feasible and practical in different general adult psychiatric settings. Clinicians interviewed found that both tools provide a useful structured approach to estimate the risk of suicide and violence. Risk scores from OxMIS and OxMIV can also be used to assist clinical decision-making for future management.

show abstract

Modifiable risk factors for inpatient violence in psychiatric hospital: prospective study and prediction model

Cited by 7 publications

References 23 publications

Feasibility and Utility of Different Approaches to Violence Risk Assessment for Young Adults Receiving Treatment for Early Psychosis

Feasibility and Utility of Different Approaches to Violence Risk Assessment for Young Adults Receiving Treatment for Early Psychosis

Integrating static and modifiable risk factors in violence risk assessment for forensic psychiatric patients: a feasibility study of FoVOx

Evaluating the Risk of Suicide and Violence in Severe Mental Illness: A Feasibility Study of Two Risk Assessment Tools (OxMIS and OxMIV) in General Psychiatric Settings

Contact Info

Product

Resources

About