A Scoping Review of Patient Involvement in Violence Risk Assessment

This scoping review aimed to summarize the published literature on patient involvement in violence risk assessment. Two research questions reviewed the extent of patient involvement and what evidence exists.

English-language peer-reviewed published articles of any methodology related to violence risk assessment toward others were included. Articles were related to forensic and mental health practice and involve patients directly in the process.

Five electronic databases were comprehensively searched, as well as the reference lists of included articles. Both authors reviewed articles for inclusion and extracted data from included articles.

Fifteen articles met the inclusion criteria. Articles reported on three approaches to patient engagement in structured violence risk assessment: how patients were involved or experienced the process, using rating scales, and using questions related to patient self-perceived risk. In relation to what evidence existed, four main themes emerged: patient views about risk and their involvement in risk assessment, comparing the predictive accuracy of patient self-rated tools with clinician-rated tools, predictive accuracy of a patient self-rated tool, and comparing risk ratings between patients and clinicians.

There is a dearth of research published about involving patients in their own risk assessment. Patients report both positive and negative experiences of the process. From cohort-type studies, results have shown that patient self-risk assessment can have a similar predictive ability to the clinician ratings related to adverse violence outcomes. Findings from studies can pave the way for future clinical research around the tools that have been developed thus far.