Risk Assessments for Acute Violence to Third Parties: A Review of the Literature

Ferris, Lorraine E.; Sandercock, Jane; Hoffman, Brian F.; Silverman, M; Barkun, Harvey; Carlisle, John C.; Katz, Cheryl

doi:10.1177/070674379704201006

Cited by 23 publications

(18 citation statements)

References 30 publications

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“…A history of owning and carrying weapons among patients with severe and enduring mental illness is a recognised risk factor for future violence (Ferris et al, 1997;Shore et al, 1989). Mental health and community-based services therefore need to be aware of the potential risk posed by the carrying of weapons, particularly if there is evidence of paranoid ideation or persecutory beliefs.…”

Section: Discussionmentioning

confidence: 97%

Methods of homicide in England and Wales: a comparison by diagnostic group

Rodway

Flynn

Swinson

et al. 2009

Journal of Forensic Psychiatry & Psychology

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Background: International literature has examined the offence characteristics of homicide in the general population, but there has been limited research investigating diagnostic differences between perpetrators who commit homicide by differing methods. Objective: To investigate the methods of homicide by people with different psychiatric diagnoses and to explore the offence characteristics of perpetrators with schizophrenia, in a seven-year (1997)(1998)(1999)(2000)(2001)(2002)(2003) national sample of homicide perpetrators in England and Wales. Results: Of the 3930 homicide perpetrators identified, over a third (36%) used a sharp instrument. The use of firearms was rare. Methods of homicide differed significantly between diagnostic groups. Perpetrators with schizophrenia were more likely to use a sharp instrument and predominantly killed a family member or spouse in the home; a significant majority were mentally ill at the time of the offence. Perpetrators diagnosed with affective disorder were more likely to use strangulation or suffocation. Alcohol dependent perpetrators used hitting or kicking significantly more often, primarily to kill acquaintances. Finally, drug dependent perpetrators were more likely to use non-violent methods, particularly poisoning. Conclusion: Methods of homicide are affected not only by the social and behavioural characteristics of the perpetrator and victim, but also by the perpetrator's psychiatric history and diagnosis.

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Section: Discussionmentioning

confidence: 97%

Methods of homicide in England and Wales: a comparison by diagnostic group

Rodway

Flynn

Swinson

et al. 2009

Journal of Forensic Psychiatry & Psychology

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“…The study of violence and aggression among forensic and psychiatric clienteles focuses largely on physical aggression directed toward others (Ferris et al, 1997). However, mental health care workers deal with a much broader range of challenging behavior on a day-to-day basis (Crocker et al, in press).…”

Section: Multiple Risk Outcomesmentioning

confidence: 99%

The Predictive Validity of Clinical Ratings of the Short-Term Assessment of Risk and Treatability (START)

Braithwaite

Charette

Crocker

et al. 2010

International Journal of Forensic Mental Health

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With the increased need to assess and manage risk in inpatient settings, the Short-Term Assessment of Risk and Treatability (START) was implemented on a civil psychiatric unit. The goal of the present study was to examine the tool's predictive validity when completed by clinical teams as part of routine practice. Data were collected for 34 patients hospitalized for a minimum of 30 days prior to and after a START evaluation. Several challenging behaviors, such as aggression towards others, self-harm, and substance abuse were assessed using the START Outcomes Scale . Results from multilevel logistic regression and Receiver Operating Characteristics analyses lend partial support for the predictive validity of the START. A limited set of START items combined was significantly better at predicting the challenging behaviors than the original total Strength and Vulnerability scales. Results are discussed in terms of the clinical use of risk assessment.

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“…While risk assessment has always been part of good clinical practice, the use of a standardised Mental Health -Research and Policy Making risk assessment tool has been promoted in the literature as an important adjunct to the process of ri s k as s e s s m e n t a n d s u b s e q u e n t ris k management 21 The risk assessment tool was developed by a group of senior clinicians following the method outlined by the Sainsbury Centre in the United Kingdom. 22 The tool contains a list of client and environmental factors that have been found in clinical practice and in the literature to be associated with aggressive behaviour.…”

Section: Risk Assessment Checklistmentioning

confidence: 99%

“…22 The identification and monitoring of risk factors assists clinicians with treatment planning, monitoring progress, and limiting legal liability. 21 Finally, the use of computerised surveillance methods to capture key information related to aggressive behaviour has also been suggested. 23,24 Summary reports enable managers to identify high risk clients (and units) and monitor the effectiveness of violence-reduction strategies.…”

Section: What Are the Implications For Practice?mentioning

confidence: 99%

“…19 The use of structured assessment tools to monitor the risk of violence among inpatients has also been promoted as a means of reducing aggressive behaviour. 20,21 The assessment of risk allows staff to make judgements about the probability of an event occurring with potentially harmful outcomes for self and others. 22 The identification and monitoring of risk factors assists clinicians with treatment planning, monitoring progress, and limiting legal liability.…”

Section: What Are the Implications For Practice?mentioning

confidence: 99%

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Reducing aggressive behaviour and staff injuries: a multi-strategy approach

Meehan¹,

Fjeldsoe²,

Stedman³

et al. 2006

Aust. Health Review

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Objective: To evaluate the impact of a multistrategy approach on the management of patient aggression and staff injury rates at a stand-alone mental health facility. Methods:A multi-strategy aggression management program was developed and introduced over a 2-year period. The program had four components; staff education/training, a staff support program, risk assessment tools, and a computerised incident monitoring system. Aggressive incidents by patients, staff injuries due to patient aggression and compensation payments to staff for the 2-year period before implementation of the aggression management program were compared with the 3-year period following implementation of the program.Results: There was a significant decrease in the number of staff injuries reported in the 3-year period following the implementation of the aggression management program. Although the number of aggressive incidents reported did decrease over the study period, the decrease was not statistically significant. Conclusions:Despite the increasing acuity of the clients at the study facility, there was a significant decrease in staff injuries due to aggressive behaviour. The strategies implemented seem to offset the potential for violence. It is likely that the combined impact of the strategies is greater than the impact of individual strategies implemented

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Risk Assessments for Acute Violence to Third Parties: A Review of the Literature

Cited by 23 publications

References 30 publications

Methods of homicide in England and Wales: a comparison by diagnostic group

Methods of homicide in England and Wales: a comparison by diagnostic group

The Predictive Validity of Clinical Ratings of the Short-Term Assessment of Risk and Treatability (START)

Reducing aggressive behaviour and staff injuries: a multi-strategy approach

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