Adrienne Saxton, MD Assistant Professor Department of Psychiatry Case Western Reserve University School of Medicine Cleveland, Ohio
Phillip Resnick, MD Forensic Psychiatry Section Editor Current Psychiatry Professor Department of Psychiatry Case Western Reserve University School of Medicine Cleveland, Ohio
Stephen Noffsinger, MD Associate Professor Department of Psychiatry Case Western Reserve University School of Medicine Cleveland, Ohio
Disclosures The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
Consider using a structured tool, such as the Classification of Violence Risk, to help identify Mr. F’s risk factors for violence, or some other formal method to ensure that the proper data are collected. Violence risk assessments are more accurate when structured risk assessment tools are used, compared with clinical judgment alone.
It is important to review collateral sources of information. In Mr. F’s case, useful collateral sources may include his criminal docket (usually available online), past medical records, information from the shelter where he lives, and, potentially, friends or family.
Because Mr. F is making threats of targeted violence, be sure to ask about attack-related behaviors (Table 130).
Regarding the seriousness of Mr. F’s intent to cause harm, it may be helpful to ask him the following questions:
How likely are you to carry out this act of violence?
Do you have a plan? Have you taken any steps toward this plan?
Do you see other, nonviolent solutions to this problem?
What do you hope that we can do for you to help with this problem?
