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Early Intervention in the Real World-Managing Risks of Violence in a Youth Mental Health Service: A Service Model Description

NCJ Number
242558
Journal
Early Intervention in Psychiatry Volume: 6 Dated: 2012 Pages: 469-475
Author(s)
Rosemary Purcell; Richard Fraser; Catherine Greenwood-Smith; Gennady N. Baksheev; Jennifer McCarthy; David Reid; Anthea Lemphers; Danny H. Sullivan
Date Published
2012
Length
7 pages
Annotation
This article provides a rationale for, and service description of, a pilot forensic satellite clinic embedded within an early intervention service for patients with emerging psychosis, mood disorder and/or personality disorders. The core elements of the program and its implementation are described, and demographic, clinical and risk data are presented for the patients assessed during the clinic's pilot phase.
Abstract
The study found a significant relationship between experiencing a severe mental illness, particularly psychosis, and exhibiting violent or offending behavior. Reducing, if not preventing, the risks of violence among patients of mental health services is clinically warranted, but models to address this are limited. Assessing and managing risks of violent offending among young patients are both clinically indicated for a proportion of patients and feasible via a forensic outreach model. Given the proliferation of early psychosis services worldwide, the issue of managing, and ideally preventing, patient risk of violence will almost certainly have wide application. However, a comprehensive evaluation of this model is required to ultimately determine the effectiveness of this approach for improving patient outcomes. A total of 54 patients were referred, 45 of whom were subsequently assessed via primary or secondary consultation. The majority of patients were male, with psychosis (40 percent) or major depressive disorder (31 percent) as the most common diagnoses. Illicit substance use in the sample was common, as was previous aggression (81 percent) and prior criminal offences (51 percent). Most referrals related to assessing and managing violent behavior (64 percent) and violent/homicidal ideation (38 percent). On the basis of the risk assessments, 71 percent of patients were rated as medium to high risk of offending. (Published Abstract)