Hospital-based Clinical Forensic Program in Violence Risk Assessment: Utilization and Management Considerations

Abstract

Introduction Risk assessment of future disruptive and violent acts is of great importance to public protection and care in the medical setting. The VA Puget Sound created a Disruptive Behavior Evaluation Clinic, which utilizes clinical forensic risk evaluations in its assessments of veterans with disruptive Patient Record Flags or at elevated risk for violent behavior. Objectives This poster will review the results of a utilization study of the Disruptive Behavior Evaluation Clinic after its first two years in operation. Aim To better understand the utilization of the clnic for future targeted interventions and allocation of resources to reduce risk of violent or disruptive behavior at the facility. Methods Medical charts of all evaluees assessed in the Disruptive Behavior Evaluation Clinic were reviewed to assess the evaluee characteristics, mental health and substance abuse histories, recommendations from the forensic evaluator, whether recommendations were followed, and disposition of persons evaluated in the facility's Disruptive Behavior Evaluation Clinic. Results Results indicate that the most common diagnoses for persons evaluated in the clinic to date were alcohol or substance use disorders, personality disorder, and primary psychotic disorders. Demographics, referral source, and disposition outcomes were tabulated. As a result of the forensic risk assessment reports generated by the clnic several evaluees subsequently qualified for housing services. Conclusion The information on utilization is helpful to better assess the characteristics of veterans most prone to violence at one VA facility. It helps the facility allocate risk reduction resources to targeted clinics or programs.