Risk colonisation. Comments on assessment and risk management of violence in psychiatry

Journal title RIVISTA SPERIMENTALE DI FRENIATRIA
Author/s Valentina Moretti, Gian Maria Galeazzi
Publishing Year 2015 Issue 2015/3 Language Italian
Pages 18 P. 71-88 File size 2211 KB
DOI 10.3280/RSF2015-003005
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Over the past decades, the issue of assessment and risk management of violence, in the field of mentally disordered offenders, has gained considerable importance. Professionals are increasingly invested with the task of assessing and managing the risk of violence. This development appears like a "risk colonisation". As a consequence, several structured risk assessment tools have appeared. These instruments should produce reliable and precise enough predictions, and help in taking complex decisions (i.e. using, or not, coercive measures). However, the authors express their general and ethical concern analysing the technical shortcomings - e.g. the insufficient positive predictive value - of these rating scales. They also highlight the current enthusiastic use of these measures in psychiatry and their impact on the patient-professional relationship. Finally, the authors suggest that the use of a therapeutic risk taking model is more appropriate, since it involves the collaboration with patients, other agencies and stakeholders, and draws on a range of human, professional, representative and advocacy skills. Thus, in the event of difficulties, this approach facilitates the co-construction of shared objectives in a sufficiently responsive and safe context.

Keywords: Violence risk assessment and management, violence, rating scales, mental health

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Valentina Moretti, Gian Maria Galeazzi, La colonizzazione del rischio. Note sulla pratica della valutazione e gestione del rischio di violenza in psichiatria in "RIVISTA SPERIMENTALE DI FRENIATRIA" 3/2015, pp 71-88, DOI: 10.3280/RSF2015-003005