Violence Risk Identification, Assessment, and Management Practices in Inpatient Psychiatry

Serious mental illness is a major risk factor for violence. Research suggests that many committed psychiatric inpatients have perpetrated violence before, during, and after hospitalization. Despite the prevalence and implications of violence among committed psychiatric patients, the responsibility of health care professionals to identify, assess and manage violence risk, and the development of identification and assessment tools to assist health care professionals in discharging their responsibility, little is actually known about what practices are being used to identify, assess, and manage violence in inpatient psychiatry units. The purpose of this study is to obtain a better understanding of violence risk identification, assessment, and management practices used by inpatient psychiatric units. Specifically, this study involved semistructured interviews with key informants from 13 inpatient psychiatry units in the largest health region in Western Canada. Every inpatient psychiatry unit that was invited to take part in this study agreed to participate. Data were analyzed using frequency and content analysis. The analysis revealed limited use of formal identification and assessment instruments for violence and diversity with respect to strategies used to manage violence. These findings have implications for highlighting promising practices that are currently being used, and identifying potential areas for future improvement.