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Evaluation of a risk assessment tool to predict violent behaviour by patients detained in a psychiatric intensive care unit

Published online by Cambridge University Press:  19 October 2011

Steve Brown  and
Martin Langrish
Steve Brown*
Affiliation:
Consultant Psychiatrist, Hampshire Partnership NHS Foundation Trust
Martin Langrish
Affiliation:
Ward manager, Hampshire Partnership NHS Foundation Trust
*
Correspondence to: Dr Steve Brown, Canon House, 6 Canon Street, Shirley, Southampton SO15 5PQ. Tel: 02380 878051. Email: steve.brown@hantspt-sw.nhs.uk
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Abstract

Background: Structured assessment of risk is a standard element of the core psychiatric assessment, particularly in respect of individuals, who are perceived to be at risk of violence or suicide. Many acute mental health trusts have introduced risk assessment tools, often without evidence of validity.

Aim: To evaluate a tool designed to predict the acute risk of violence by patients detained in a PICU.

Method: A risk assessment form was completed weekly for each patient on the PICU. Multivariate logistic regression analysis was used to measure the predictive value of particular variables in respect of violent behaviour during the next two weeks.

Results: Violent behaviour during the previous two weeks was a significant predictor of subsequent violence. Drug use was a negative predictor. None of the other variables tested were predictive of violent behaviour.

Conclusions: A complicated risk assessment tool probably adds little to the process of predicting acutely violent behaviour in PICU patients. The introduction of procedures such as structured risk assessment tools should be subject to the same validation process as any other clinical initiative.

Keywords

Psychiatric unitintensive carerisk assessmentviolence
Type
Original Research Article
Information
Journal of Psychiatric Intensive Care , Volume 8 , Issue 1 , April 2012 , pp. 35 - 41
Copyright
Copyright © NAPICU 2011

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