Assessing and managing the risk of violence to others

Assessing and managing the risk of patient violence is integral to the clinical practice of psychiatry. This chapter reviews the principles governing the assessment of violence risk in psychiatry, discusses clinical practice in this area, and examines the limits of psychiatric violence risk assessment. Assessment involves both the identification of risk and protective factors and a cause-based analysis based on an understanding of the case. Good practice involves the use of multiple sources of information and the integration of information gleaned from the identification of correlates of violence and a cause-based analysis. Empirical data on the limits to the predictive accuracy that can be achieved suggest that information concerning risk will usually be one of many pieces of information governing the management of a case.