Evidence-Based Reviews

Chief complaint: Homicidal. Assessing violence risk

Author and Disclosure Information

 

References

Bottom Line

Use a structured approach to identify risk factors for violence. Address dynamic risk factors, including access to weapons. Carry out the duty to warn/protect if applicable. Document your decisions and actions carefully, and then discharge the patient if clinically indicated. Do not be “held hostage” by a patient’s homicidal ideation.

Related Resources

  • Dolan M, Doyle M. Violence risk prediction. Clinical and actuarial measures and the role of the psychopathy checklist. Br J Psychiatry. 2000;177:303-311.
  • Douglas KS, Hart SD, Webster CD, et al. HCR-20V3: Assessing risk of violence–user guide. Burnaby, Canada: Mental Health, Law, and Policy Institute, Simon Fraser University; 2013.
  • National Conference of State Legislatures. Mental health professionals’ duty to warn. http://www.ncsl.org/research/health/mental-health-professionals-duty-to-warn.aspx. Published September 28, 2015.

Drug Brand Names

Sertraline • Zoloft

Pages

Recommended Reading

The DNA of psychiatric practice: A covenant with our patients
MDedge Psychiatry
The Goldwater Rule and free speech, the current 'political morass', and more
MDedge Psychiatry
Strategies for working with patients with personality disorders
MDedge Psychiatry
Treating psychosis in patients with HIV/AIDS
MDedge Psychiatry
Aggressive outbursts and emotional lability in a 16-year-old boy
MDedge Psychiatry
‘Nocebo’ effects: Address these 4 psychosocial factors
MDedge Psychiatry
Career Choices: Directorship/leadership
MDedge Psychiatry
‘Robotripping’: What residents need to know
MDedge Psychiatry
Tardive dyskinesia: Screening and management
MDedge Psychiatry
Is medical aid in dying suicide?
MDedge Psychiatry