Risk management during the transition from hospital to community care

Abstract

Summary There is a dearth of research on risk management of violent patients during the phase of transition from hospital to community care. Discharge can only be contemplated when identified risk factors are managed and tested in non-secure environments. Therefore this process should proceed cautiously and over as protracted a period as circumstances allow. A gradated programme which caters for various levels of risk allows for the testing of measures within a relatively well controlled milieu. Initial measures would include anticipating and preparing for future living arrangements (especially accommodation, supervision, finances) and psychoeducation for the patient and care givers. Specific risk factors, such as co-morbidity (especially alcohol and substance abuse), and relationship difficulties may need specialized or particular individual interventions. Increasingly cultural issues will have to be considered and incorporated into management plans.