Treatment engagement and violence risk in mental disorders
ABSTRACT Research has uncovered many characteristics related to violence committed by people with mental illness. However, relatively few studies have focused on understanding the connection between violence and dynamic, malleable variables such as a patient's level of treatment engagement.
To explore the link between community violence and patients'beliefs about psychiatric treatment benefit.
A sample of 1011 adults receiving out-patient treatment for a psychiatric disorder in the public mental health systems of five US states were interviewed.
Bivariate analyses revealed community violence was inversely related to treatment adherence, perceived treatment need and perceived treatment effectiveness. Multivariate analyses showed these three variables were associated with reduced odds of violent and other aggressive acts.
The results suggest clinical consideration of patients' perceptions of treatment benefit can help enhance violence risk assessment in psychiatric practice settings.
- SourceAvailable from: Yenal Dundar
- 03/2014; 13(1):75-90. DOI:10.1080/14999013.2014.885471
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ABSTRACT: A Wisconsin Case: In their regular 4 PM appointment, an experienced psychologist was listening to his client escalate into angrier and angrier talk. He was becoming violent. The man had a history of violence, but had been on medications for years. Once his family took on the duty of monitoring his medication compliance, there had been no more trouble with angry outbursts and assaultiveness. But something had changed. The psychologist began thinking about the Wisconsin "duty to warn" standards. This was a major mistake. The man suddenly arose, taking the psychologist by surprise, and began to strangle him. After a terrible fight, both were knocked out. The psychologist awoke first, called 911, and the police came. Finding that the client was dead, they held the traumatized psychologist at gunpoint and transferred him under guard to a hospital to get care for his 37 stab wounds (from a letter opener which was on the desk. The prosecutor then spent months whether to charge the psychologist with murder.