A Predictive Model for Estimating Risk of Harm and Aggression in Inpatient Mental Health Clinics.

Emanuele Blasioli,Peter J Bieling,Elkafi Hassini

doi:10.1007/s11126-020-09880-w

Emanuele Blasioli, Peter J Bieling + Show 1 more

Open Access

https://doi.org/10.1007/s11126-020-09880-w

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Abstract

Serious mental illness is a major risk factor for aggression and violence. The present study aimed to develop and test an algorithm to predict inpatient aggressions that involve a risk of harm to self or others. This work is based on a retrospective study aimed to investigate the prediction of risk of harm and aggressions at St. Joseph's Healthcare Hamilton, between 2016 and 2017. An analysis of the risk factors most strongly associated with harmful incidents is, followed by the description of the process involved in the development of a predictive model which estimates the risk of harm. The efficiency of the model developed is finally evaluated, showing an overall accuracy of 75%: the specificity to identify episodes considered not at risk of harm is equal to 91.85%, whereas the sensitivity to identify episodes considered harmful is equal to 28.57%. The model proposed can be seen as a seminal project towards the development of a more comprehensive, precise and effective tool capable to predict the risk of harm in the inpatient setting.

Highlights

Serious mental illness is a major risk factor for aggression and violence
The model proposed can be seen as a seminal project towards the development of a more comprehensive, precise and effective tool capable to predict the risk of harm in the inpatient setting
Violence risk prediction within the inpatient psychiatry setting is seen as a priority in mental health care

Summary

Introduction

Serious mental illness is a major risk factor for aggression and violence. Violence risk prediction within the inpatient psychiatry setting is seen as a priority in mental health care. Violence affects both patients and staff, decreasing staff’s productivity and morale, as well as the quality of services offered (Fisher, 2016). The literature addressing inpatient violence is vast, and some factors have been demonstrated to be significantly associated to this phenomenon. Personality disorders, in particular the antisocial and borderline personality disorders, resulted significantly associated to episodes of inpatient aggressions (Fisher, 2016; Steinert, 2002)

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