Assessing Risk for Aggression in a Forensic Psychiatric Hospital Using the Level of Service Inventory-Revised: Screening Version

Abstract

The assessment of risk for aggression has become a central concern of many mental health services. Some structured schemes for guiding risk assessment, developed primarily to assess risk in psychiatric patients discharged from hospital and offenders being considered for release from prison, have recently been trialled in the inpatient setting. Against the background of some prior research demonstrating the potential benefits of structured assessment schemes, and some concerns about the practicality of these schemes for assessing risk in inpatients, the current research was initiated to assess the effectiveness of the Level of Service Inventory-Revised: Screening Version (LSI-R: SV) in the prediction of aggression within a forensic psychiatric hospital. Results showed that only a weak association between the LSI-R: SV total score and inpatient aggression existed. This is probably because the LSI-R: SV addresses more static variables and does not assess the clinical characteristics and recent hostility that is associated with aggression in psychiatric patients. The predictive validity of the LSI-R: SV in this context is therefore limited. There might be more effective schemes, some of which were designed specifically for the purpose of assessing inpatient aggression that should be used in preference to the LSI-R: SV.