Improving violence risk assessment and management in mental health and substance use services

Aim: To develop a Toolkit (Improving Risk Assessment and Management of Violence – IRAMV) to augment and enhance currently available violence prevention training to increase provider confidence and effectiveness in this important domain.

Summary: 

Violent behaviour is a significant challenge in health care, particularly in mental health and substance use settings,where the prevalence of violent behaviour toward professionals is five times greater than in all occupations overall (Freidman RA 2006). Interdisciplinary team members often perform risk screening assessment and care management for community based violence in the absence of standardized and evidence informed guidelines. Current provincial violence prevention training strategies often do not sufficiently address physician needs in managing violence nor address providers’ duty to protect the public.

Management of violent behaviour is increasingly challenging in an era of restricted healthcare budgets,deinstitutionalization and barriers to healthcare access. Violence is also common in general medical settings where staff may have limited training in early identification and prevention of risk, resources may be difficult to access and the effects of violent incidents are significant. Individuals may be ‘flagged’ for violence risk based on providers’ limited information and understanding of factors contributing to risk, thus creating unnecessary stigma and further barriers to access of services. Persons with conditions that increase their risk of violence present across all health care settings. Additionally, such individuals often have complex medical, psychiatric and substance use comorbidity increasing violence risk.

The goal of this quality improvement, educational project was to develop a Toolkit (entitled “Improving Risk Assessment and Management of Violence”, or “IRAMV”) to augment and enhance currently available violence.
 

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