Risk Management In Mental Health Services Page 43
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544.3.3
Assessing the Risk of Violence
Research findings (Alaszewski et al, 1998) suggest that most mentally ill
people present a greater risk to themselves than to others.
Violence Risk Factors
Past behaviour does predict future behaviour but not absolutely. Dynamic
components, such as changes in personality, environment, work status and
personal relationships, have an important role to play also.
As well as following the steps of clinical risk assessment outlined in
Chapter Three, the following parameters should be considered in
assessing signs of risk of violence (this is not an exhaustive list):
Components
Examples
History
A history of violence
A history of conduct disorder
A history of non-adherence and/or treatment
attrition (etc.)
Clinical
Command hallucinations are of particular risk
The manic phase of a bi-polar disorder
Impulse control disorders (including self-harming
behaviours)
Drug or alcohol use problems (etc.)
Disposition
Anger and emotional control problems
Impulsivity
Low frustration tolerance
Anti-social cognitions, beliefs or behaviours (etc.)
Context/
Non-stable, non-supportive family environments
Environment
Fractured family and/or personal relationships
Age: e.g. Youth is highly associated with violent crime
Gender: Males show higher rates of violence (etc.)
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