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

Abstract

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.

Workplace Violence among British Columbia Nurses Across Different Roles and Contexts

“…We also found acute care nurses that worked in emergency departments, psychiatric and medical/surgical specialties reported the highest prevalence of almost all types of workplace violence. Earlier research identified these nursing specialties as high-risk areas [7,25,26]. However, there seems to be a shift in the pattern of workplace violence across nursing specialties.…”

The challenges of using structured risk assessment instruments in forensic psychiatric care

“…The ability of psychiatric patients to freely consent to participation in research without feeling pressured has also been discussed (Hall & Duperouzel, 2011;Sullivan, 2005). There is some research evidence to suggest that mentally ill patients are capable of freely consenting to participation in research without feeling pressured (Magyar et al, 2012) and can successfully assess and communicate their own risk for future selfharm (Peterson et al, 2011;Ghio et al, 2011) and violence (Lockertsen et al, 2018;Skeem et al, 2013;Meehan et al, 2006;Roaldset and Björkly, 2010). Staff and researchers' willingness and ability to provide opportunities for patient involvement can influence patient's ability to participate in research (Storm and Edwards, 2013;Skeem et al, 2013).…”

“…When such differences are not recognized and managed in a constructive way, it might become a barrier to successful recovery from mental illness and risk management (Reynolds et al, 2014). The need to extend the evolving research on involvement of psychiatric inpatients in risk assessment and management (Dickens, 2015;Lockertsen et al, 2018;Buch Gudde et al, 2015;Eidhammer et al, 2014), and to investigate their perception about risk and protective factors (Lockertsen et al, 2018) has been stressed.…”

Self-Perception of Dependence as an Indicator of Smartphone Addiction. Establishment of a Cut-off Point in the SPAI-SP Inventory

“…In diverse studies, validated scales have been compared asking users to express their opinion regarding the risk indicated or perceived by them [15,16]. It is important to emphasize that the degree of problem recognition that anyone has is related to the valence of the content of their personal scheme related to consumption [17].…”

“…Therefore, self-perception has been widely used in different studies as an indicator of disease. In this sense, it has been evaluated some factors such as the association of self-perception with the dependence on text messages [7], the use / addiction to pornography and personality factors [18], the reasons and barriers in the search for help in gambling problems [19], risk of committing violence [16], alcohol dependence [17,20], the predictors of the change in alcohol consumption habits [21]. Even the self-perception of physical health has been related as a predictive factor in the use of health services [22] or the degree of participation in endurance sports and self-report data on self-image, physical and psychological health and style of life in general [15].…”