Workplace Violence: APNA 2008 Position Statement

Executive Summary Introduction Inpatient Violence in Psychiatric Settings Outpatient Psychiatric Settings
Recommendations for Inpatient and Outpatient Settings Appendix Acknowledgments References
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Interventions

Risk Assessment and Screening

To determine the risk of violence, psychiatric clinicians should utilize a screening tool (Rew & Ferns, 2005). Screening and risk assessment tools used in combination with traditional clinical assessment techniques can help clinicians form clinical impressions regarding violence risk.

Otto (2008) discussed the use in the outpatient setting of the HCR-20, an evaluation guide that covers 20 assessment areas relevant to identifying a client’s potential for violence. The first section of this tool focuses on the client’s history of violence, examining factors such as age of first violent incident, relationship instability, employment problems, substance use, major mental illness, early maladjustment, psychopathology, personality disorders, and prior supervision failure. The second section identifies clinical factors such as lack of insight, negative attitudes, active symptoms of mental illness, impulsivity, and unresponsiveness to treatment. The third section focuses on risk management items, such as feasibility of violent plans, exposure to weapons or substance use, lack of personal support, noncompliance, and stress. The HCR-20 can be reliably scored and has some predictive power compared with other violence risk assessment instruments (Otto, 2008).
 

Executive Summary Introduction Inpatient Violence in Psychiatric Settings Outpatient Psychiatric Settings
Recommendations for Inpatient and Outpatient Settings Appendix Acknowledgments References
Download the full PDF
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