A Clinician's Guide to Violence Risk Assessment in Persons with Serious Mental Illness-Presentation Slides

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The document is a clinician's guide to violence risk assessment in persons with serious mental illness. It is part of the Clinical Support System for Serious Mental Illness (CSS-SMI) initiative funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and implemented by the American Psychiatric Association (APA). The guide covers various aspects of violence risk assessment, including the challenges clinicians face in considering violence risk assessment, studies examining the relationship between serious mental illness and violence, and clinical approaches to violence risk assessment and risk mitigating interventions.<br /><br />Some of the challenges clinicians face in violence risk assessment include conducting rapid assessments in emergency room settings, limited data to inform risk assessment in various settings, limited training of evaluators, and the ever-evolving research and risk assessment tools. Studies have shown that most persons with mental illness are not violent, and the majority of violence is not caused by persons with mental illness. However, substance use is a major risk factor for violence, and there is a small relationship between violence and mental illness.<br /><br />Clinical approaches to violence risk assessment involve considering various risk factor variables such as demographic, historical, situational, and clinical factors. Demographic risk factors include late teens or early 20s, males, lower socioeconomic status, lower IQ, employment instability, and residential instability. Historical risk factors include past violence, age at first offense, pattern and frequency of violence, degree of harm towards others, and the level of planning or impulsivity.<br /><br />The guide also discusses the use of structured assessments and violence risk assessment tools, such as the Violence Risk Appraisal Guide, Historical Clinical Risk Management-20, and Iterative Classification Tree Method. Additionally, the guide highlights the importance of reducing violence in persons with schizophrenia and the potential benefits of treatments like clozapine when conduct disorder is present.

Keywords

clinician's guide

violence risk assessment

serious mental illness

Clinical Support System for Serious Mental Illness

challenges clinicians face

relationship between serious mental illness and violence

clinical approaches

risk mitigating interventions

structured assessments

violence risk assessment tools