scholarly journals Assessing violence risk in general adult psychiatry

2005 ◽  
Vol 29 (4) ◽  
pp. 131-133 ◽  
Author(s):  
Nicola Higgins ◽  
David Watts ◽  
Jonathan Bindman ◽  
Mike Slade ◽  
Graham Thornicroft
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Content Analysis ◽  
Current Practice ◽  
Clinical Implications ◽  
Violence Risk ◽  
Assessment Practice ◽  
Adult Psychiatry ◽  
Harm To Others ◽  
Current Risk

Aims and MethodWe aimed to establish current practice in the risk assessment of harm to others within general adult psychiatry and review risk assessment documentation in use. Consultants working across 66 randomly selected trusts across England were surveyed. A qualitative analysis of risk assessment documentation was carried out.ResultsData were obtained from 45 trusts (68%). Consultants reported that 30 (67%) of the trusts had standardised forms for risk assessment. Forty-one forms were subjected to content analysis. Wide variation was found in the methods used to identify risk factors and in approaches to quantifying risk.Clinical ImplicationsCurrent risk assessment practice is highly variable, indicating a lack of consensus about suitable methods.

scholarly journals An audit of risk assessment in an emergency setting

2002 ◽  
Vol 26 (3) ◽  
pp. 88-90 ◽  
Author(s):  
James Stone ◽  
George Szmukler
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Emergency Setting ◽  
Patient Records ◽  
Changing Practice ◽  
Self Harm ◽  
Harm To Others ◽  
The Way

Aims and MethodPatient records from the emergency clinic at the Maudsley Hospital were analysed from July 1999 to assess the standard of risk assessment for self-harm and for harm to others routinely recorded by junior doctors. The recorded risk factors for the consultation and the evidence that risk had been considered were noted. An intervention that comprised two seminars and two written reminders about the importance of risk assessment was made and the analysis of records in the emergency clinic repeated for July 2000.ResultsRisk factors were recorded more frequently for harm to self than for harm to others. There was little recorded evidence that consideration had been given to the overall risk of harm to self, and there was no evidence of this for harm to others. Recording of risk did not change significantly between 1999 and 2000.Clinical ImplicationsAssessment for risk of harm to others is not a part of the emergency consultation that is emphasised by the majority of junior psychiatrists. Changing practice will require a shift in the way that risk to others is presented in psychiatric teaching.

scholarly journals Assessment of violence risk in 440 psychiatric patients in China: examining the feasibility and acceptability of a novel and scalable approach (FoVOx)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaoling Zhong ◽  
◽  
Rongqin Yu ◽  
Robert Cornish ◽  
Xiaoping Wang ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Risk Assessment ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Psychiatric Patients ◽  
Clinical Decision ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Risk Categories

Abstract Background Violence risk assessment is a routine part of clinical services in mental health, and in particular secure psychiatric hospitals. The use of prediction models and risk tools can assist clinical decision-making on risk management, including decisions about further assessments, referral, hospitalization and treatment. In recent years, scalable evidence-based tools, such as Forensic Psychiatry and Violent Oxford (FoVOx), have been developed and validated for patients with mental illness. However, their acceptability and utility in clinical settings is not known. Therefore, we conducted a clinical impact study in multiple institutions that provided specialist mental health service. Methods We followed a two-step mixed-methods design. In phase one, we examined baseline risk factors on 330 psychiatric patients from seven forensic psychiatric institutes in China. In phase two, we conducted semi-structured interviews with 11 clinicians regarding violence risk assessment from ten mental health centres. We compared the FoVOx score on each admission (n = 110) to unstructured clinical risk assessment and used a thematic analysis to assess clinician views on the accuracy and utility of this tool. Results The median estimated probability of violent reoffending (FoVOx score) within 1 year was 7% (range 1–40%). There was fair agreement (72/99, 73% agreement) on the risk categories between FoVOx and clinicians’ assessment on risk categories, and moderate agreement (10/12, 83% agreement) when examining low and high risk categories. In a majority of cases (56/101, 55%), clinicians thought the FoVOx score was an accurate representation of the violent risk of an individual patient. Clinicians suggested some additional clinical, social and criminal risk factors should be considered during any comprehensive assessment. In addition, FoVOx was considered to be helpful in assisting clinical decision-making and individual risk assessment. Ten out of 11 clinicians reported that FoVOx was easy to use, eight out of 11 was practical, and all clinicians would consider using it in the future. Conclusions Clinicians found that violence risk assessment could be improved by using a simple, scalable tool, and that FoVOx was feasible and practical to use.

Evaluating Violence Risk in Children and Adolescents

2015 ◽  
Author(s):  
Randy Borum
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Children And Adolescents ◽  
Health Professionals ◽  
Risk Level ◽  
Evidence Based ◽  
Violence Risk ◽  
Developmental Context ◽  
Emergency Workers ◽  
Behavioral Emergencies

Emergency workers and behavioral health professionals who work in crisis or emergency settings should understand the fundamentals of assessing and managing violence risk in children and adolescents, but violence potential must be considered in its developmental context. This chapter presents an approach for assessing violence risk among youth in the context of behavioral emergencies. It begins with a brief discussion of the developmental context for risk assessment and how to think about violent outcomes among children and adolescents. Then, it covers the information an evaluator would need to collect, how to collect it, and how to reach a sound decision about a youth’s risk level. It encourages evaluators in emergency or crisis settings to rely on evidence-based risk factors, while also applying individualized formulations to give texture to the assessments and to the subsequent forecasts about the nature and degree of risk for violence.

scholarly journals Developing a clinically useful actuarial tool for assessing violence risk

2000 ◽  
Vol 176 (4) ◽  
pp. 312-319 ◽  
Author(s):  
John Monahan ◽  
Henry J. Steadman ◽  
Pamela C. Robbins ◽  
Eric Silver ◽  
Paul S. Appelbaum ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Clinical Utility ◽  
Psychiatric Patients ◽  
Classification Tree ◽  
Base Rate ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
High Degree ◽  
Actuarial Method

BackgroundA new actuarial method for violence risk assessment – the Iterative Classification Tree (ICT) – has become available. It has a high degree of accuracy but can be time and resource intensive to administer.AimsTo increase the clinical utility of the ICT method by restricting the risk factors used to generate the actuarial tool to those commonly available in hospital records or capable of being routinely assessed in clinical practice.MethodA total of 939 male and female civil psychiatric patients between 18 and 40 years old were assessed on 106 risk factors in the hospital and monitored for violence to others during the first 20 weeks after discharge.ResultsThe ICT classified 72.6% of the sample as either low risk (less than half of the sample's base rate of violence) or high risk (more than twice the sample's base rate of violence).ConclusionsA clinically useful actuarial method exists to assist in violence risk assessment.

Auditing Firms' Fraud Risk Assessment Practices

2001 ◽  
Vol 15 (1) ◽  
pp. 19-33 ◽  
Author(s):  
Sandra Waller Shelton ◽  
O. Ray Whittington ◽  
David Landsittel
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Academic Research ◽  
Financial Statements ◽  
Assessment Practices ◽  
Assessment Practice ◽  
Big 5 ◽  
Fraud Risk ◽  
Audit Firms ◽  
Second Tier

The effectiveness of audits in detecting fraudulent misstatements in financial statements is of major concern to the auditing profession. This concern led to the issuance of Statement on Auditing Standards (SAS) No. 82, which made several changes in the manner in which auditors are required to consider the risk of material misstatements due to fraud. This manuscript reports the results of a study of the practices of CPA firms in implementing SAS No. 82. We compared audit manuals and practice aids and interviewed firm personnel from all of the Big 5 firms and two second-tier firms. Results of this study indicate that audit firms differ as to (1) whether their practice aids for fraud risk assessment are separate or integrated with other risk assessment practice aids, (2) the timing of the fraud risk assessment, and (3) the method of assessing fraud risk. Furthermore, although all of the firms studied include all of the SAS No. 82 factors in their audit practice aids, certain other fraud risk factors identified in academic research are not included in firm practice aids.

Risk Assessment

Criminology ◽  
2014 ◽  
Author(s):  
Ashley A. Pritchard ◽  
Adam J. E. Blanchard ◽  
Kevin S. Douglas
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Psychiatric Patients ◽  
Poor Performance ◽  
Professional Judgment ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Dynamic Risk Factors ◽  
Forensic Patients ◽  
Empirically Supported

Violence risk assessment is the process of identifying the level of risk for future violence posed by offenders, forensic patients, and civil psychiatric patients. In each such context, whether persons are detained or released into the community is a decision governed by law. The field of violence risk assessment has witnessed tremendous growth over the past several decades. With few exceptions, its use in numerous legal settings has been upheld by courts, and in some cases professionals have positive duties to conduct risk assessments and protect potential victims. After early research findings suggesting very poor performance of clinicians in predicting violence, a great deal of research has focused on improving risk assessment. Several hundred studies have now been conducted on structured approaches to risk assessment (e.g., actuarial prediction, structured professional judgment). Similarly, a great amount of scientific attention has been paid to identifying empirically supported violence risk factors. More recently, scholars have been focusing on identifying so-called dynamic risk factors, or those that are changeable and of most relevance to intervention. Current themes in risk assessment include focusing on how risk assessment can inform risk management and risk reduction and how best to integrate risk assessment technology into actual practice.

Finding Colour in Conformity Part II—Reflections on Structured Professional Judgement and Cross-Cultural Risk Assessment

2020 ◽  
Vol 65 (1) ◽  
pp. 92-99
Author(s):  
Stephane M. Shepherd ◽  
Benjamin L. Spivak
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cross Cultural ◽  
The Past ◽  
Specific Risk ◽  
Growing Body ◽  
Current Risk ◽  
Professional Judgement

There has been an increasing interest in cross-cultural risk assessment over the past 5 years. Much of this has been driven by concerns that particular risk instruments may be biased against, or ill-suited to, non-White offending populations. A growing body of work has asserted that unique cultural-specific risk factors and experiences may not be adequately considered within current risk assessment frameworks which have led to calls to culturally alter/remodel risk instruments. While recognising the importance of generalizable risk instruments, this article outlines a number of realities that cross-cultural risk assessment researchers must contend with before embarking on projects to alter instruments. With specific regard to structured professional judgement risk instruments, the article notes that efforts to culturally amend instruments, could paradoxically reduce accuracy and increase bias.

scholarly journals Feasibility of a structured risk assessment tool in general adult psychiatry admissions

2007 ◽  
Vol 31 (11) ◽  
pp. 418-420 ◽  
Author(s):  
Helen Smith ◽  
Tom White
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Personality Disorder ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Clinical Implications ◽  
Royal Hospital ◽  
Comorbid Diagnosis ◽  
Adult Psychiatry ◽  
Risk Patients

AIMS AND METHODTo assess the feasibility of using a structured risk assessment tool (Historical Clinical Risk 20-Item (HCR–20) Scale) in general adult psychiatry admissions and the characteristics of ‘high-risk’ patients. A notes review and interviews were used to conduct an HCR–20 assessment of 135 patients admitted to Murray Royal Hospital, Scotland.RESULTSPatients scoring higher on the HCR–20 were discharged earlier and more likely to have a diagnosis of personality disorder and a comorbid diagnosis.CLINICAL IMPLICATIONSIt was possible to complete an HCR–20 assessment of over 80% of patients within 48 h of admission.

scholarly journals Risk Management – Decision Making Using Analytical Hierarchy Process

2018 ◽  
Vol 7 (3.12) ◽  
pp. 188
Author(s):  
Neha P Asrani ◽  
C Venkatasubramanian ◽  
D Muthu ◽  
Padmashree S ◽  
K Ramakrishnan
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Analytical Hierarchy Process ◽  
Objective Evaluation ◽  
Management Decision ◽  
Assessment Practice ◽  
Eigen Values ◽  
Management Decision Making ◽  
Major Factors ◽  
Hierarchy Process

A risk assessment practice determines the risk both quantitatively and qualitatively, such that risks are analysed and assessed thoroughly. Several methods are available to mitigate the failures in a construction project. This project focuses on identifying risks and mitigating them to reduce failures. On a questionnaire basis, a survey from various employees working on different projects is conducted by considering seven major factors of risks and the normalised score of each factor is ranked. Based on the normalized score values, least three risk factors were identified and Analytical Hierarchy Process(AHP) is applied by manual calculations. AHP is based on human judgements and objective evaluation, which examines the consistency of the evaluation by Eigen values. Validation of the identified factors is also done through MAT Lab and is compared with the manual method. Consistency and hierarchy of the identified factors has been found out, thereby mitigating the failures and increasing the efficiency of the projects.  

scholarly journals Risk assessment and management: forensic methods, human results

2013 ◽  
Vol 19 (5) ◽  
pp. 358-365
Author(s):  
John Baird ◽  
Ruth Stocks
Keyword(s):  
Risk Assessment ◽  
Clinical Practice ◽  
Best Practice ◽  
Current Practice ◽  
Clinical Judgement ◽  
Illustrative Case ◽  
Clinical Team ◽  
Harm To Others ◽  
Risk Assessment And Management ◽  
Management Of Risk

SummaryRisk assessment and management is an integral part of modern clinical practice. In this article we discuss best practice in the assessment and management of risk of harm to others. Unstructured clinical judgement methods have been used for many years, but it is only more recently that actuarial and structured clinical judgement methods have been introduced. These methods are discussed and compared. We describe a process that could be followed by a clinical team and give an illustrative case example. Last, we reflect on aspects of current practice and consider the possible direction of developments in the field.

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