Risk Assessment: A Reflection on the Principles of Tools to Help Manage Risk of Violence in Mental Health

Abstract

The proposition that the vast majority of persons experiencing mental illness will never be violent is complicated by the large body of literature demonstrating a heightened risk of violent behaviour in persons suffering from mental disorder. In an era in which resources and individual judgement appear to dictate treatment, the question arises as to why structured clinical judgement is not utilized more in front-line assessment of risk for violence in those with mental and personality disorders? Our review of the literature on mental disorder and violence, risk assessment and risk management led to the contention that front-line mental health professionals can employ structured clinical judgement underpinned by the principles of risk assessment tools, such as the HCR-20. Ongoing resource development, education and availability of expertise should aid the development of more uniform approaches to violence risk management and therapeutic amelioration of the likelihood for violence in persons affected by mental illness.

Key words:

• HCR-20
• mental disorder
• mental illness
• risk assessment
• risk assessment tools
• risk management
• violence

Acknowledgment

The authors wish to thank the Justice Health & Forensic Mental Health Network for their support in the preparation of this article.