Somewhere over the Rainbow: Improving Violence Risk Management in Institutional Settings

Abstract

Tackling violence in prisons and forensic institutions is a key role for mental health professionals. Major strides have been made in the last twenty years in the evaluation and management of individual risk factors. However, the understanding of situational—or institutional—risk factors is less well developed. This special section considers PRISM. PRISM is a set of structured professional guidelines for assessing and managing the risk of violence in institutions. In contrast to better known forms of structured judgment approaches the focus of concern is the functioning of the institution, not the individual patient or prisoner. In this introductory paper we describe the development of PRISM, its conceptual and empirical base, and demonstrate and propose a range of applications for the approach. We argue that PRISM can have value in a range of important practical tasks, but also, PRISM can be used to enhance our theoretical understanding of the risk processes that underpin institutional violence.

Keywords:

• PRISM
• institutional violence
• violence risk
• public health models of violence

We would like to thank several people and agencies who have been instrumental in bringing this project to fruition. We are grateful to Brian Rae, now retired Research and Development Manager, NHS Greater Glasgow and Clyde, Dr. James Carnie and Ed Wozniak, Scottish Prison Service, members of the Scottish Prison Service Advisory Group, all the multidisciplinary staff teams at the 5 Scottish Prisons where we piloted PRISM. We are also grateful to Dr. Lisa Gadon who contributed to the projects underpinning the development of PRISM. For more information about PRISM please see http://www.gcal.ac.uk/prism/index.html