Clinical decision-making about inpatient violence risk at admission to a public-sector acute psychiatric hospital.
This is an examination of the extent to which patients who are violent in the hospital can be distinguished from nonviolent patients, based on information that is readily available at the time of admission to a state acute psychiatric hospital. The charts of 235 inpatients were examined retrospectively, by selecting 103 patients who had engaged in inpatient violence and comparing them with 132 randomly selected patients who had not during the same period. Data were gathered from initial psychiatric assessment and admissions face sheets in patients' charts, reflecting information available to a mental health professional within the first 24 hours of a patient's admission. Multivariate analysis showed that violent and nonviolent patients were distinguished by diagnosis, age, gender, estimated intelligence, psychiatric history, employment history, living situation, and agitated behavior. These factors led to an 80 percent correct classification of violent patients and thus may assist clinicians to structure decision-making about the risk of inpatient violence.
Forensic Psychiatry Program and Clinic, University of North Carolina-Chapel Hill School of Medicine, Department of Psychiatry, CB 7167, Chapel Hill, NC 27599, USA. virginia_newton@med.unc.edu
Virginia M
VM
Newton
Eric B
EB
Elbogen
Carrie L
CL
Brown
Jennifer
J
Snyder
Ann Louise
AL
Barrick
D000293:Adolescent; D000328:Adult; D003657:Decision Making; D005260:Female; D006778:Hospitals, Psychiatric; D006779:Hospitals, Public; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008485:Medical Audit; D015999:Multivariate Analysis; D010343:Patient Admission; D012189:Retrospective Studies; D018570:Risk Assessment; D014754:Violence; D055815:Young Adult