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37 Crim. Just. & Behavior 5 (2010)

handle is hein.journals/crmjusbhv37 and id is 1 raw text is: CHRONIC VIOLENT PATIENTS IN AN INPATIENT PSYCHIATRIC HOSPITAL Prevalence, Description, and Identification PATRICK LUSSIER SIMON VERDUN-JONES NADINE DESLAURIERS-VARIN Simon Fraser University TONIA NICHOLLS BC Mental Health and Addiction Services, University ofBritish Columbia, and Simon Fraser University JOHANN BRINK Simon Fraser University, BC Mental Health and Addiction Services, and University ofBritish Columbia 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 defin- ing 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 sci- entific literature on the risk management of inpatient violence. Keywords: risk assessment; inpatient; aggression; violence; chronic violent patients; psychiatric units In recent years, the perpetration of violence by psychiatric patients during inpatient treat- ment has received considerable attention. These manifestations often result in short-term and long-term psychological suffering, physical injury, medical and legal expenses, and gen- eral distress for the staff and patients (Flannery, 2002; Johnson, 2004). Concerns about the consequences of violence against staff and copatients led to the proliferation of prevention and intervention strategies to modify and decrease the risk of violence (Livingston, Verdun- Jones, Brink, Lussier, & Nicholls, in press). This proliferation has been accompanied by the emergence of actuarial tools to screen violent patients. These tools, however, have been developed to screen violent recidivism following prison release or hospital discharge (e.g., Quinsey, Harris, Rice, & Cormier, 1998). The distinction between violence during hospital AUTHORS' NOTE: The authors are grateful for the financial support provided by BC Mental Health and Addiction Services. The authors wish to thank Dr. Curt R. Bartol and several anonymous reviewers for their thoughtful comments. An earlier version of this study was presented at the annual meeting of the Canadian Psychiatric Association in Toronto (November 2006). Please address correspondence to Patrick Lussier, PhD, School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada V5A 1S6; e-mail: plussiersfu.ca. CRIMINAL JUSTICE AND BEHAVIOR, Vol. 37 No. 1, January 2010 5-28 DOI: 10.1177/0093854809347738 0 2010 International Association for Correctional and Forensic Psychology 5

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