Chronic Violent Patients in an Inpatient Psychiatric Hospital

Abstract

This study examines the prevalence and the individual characteristics of chronically violent patients (CVPs) in a psychiatric hospital during inpatient treatment. The study is based on a 1-year follow-up investigation of all violent episodes committed by a sample of 527 patients in a forensic psychiatric hospital in British Columbia, Canada. Sociodemographic, legal and criminological, historical, and clinical factors were analyzed using a risk assessment scheme. Approximately 10% of the sample was responsible for more than 60% for all violent episodes recorded during the study period. Those CVPs were characterized by historical, but mostly clinical, risk factors. Moderate to good predictive accuracy was achieved when defining CVPs as individuals who perpetrated 15 or more violent episodes. Important limitations of the actuarial approach were also highlighted by the presence of two qualitatively different groups of CVPs. The results are discussed in light of the scientific literature on the risk management of inpatient violence.