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Historically, the focus on inpatient units has not been the prevention or management of violence risk, but reacting to the violence after an incident. Violence on these units leads to physical, emotional, and economic consequences for perpetrators, victims, and the mental health system. Although short-term risk assessments have been developed to specifically address the risk for inpatient violence, these measures have only been implemented on the inpatient units and not in the Emergency Department (ED), which is often the first point of contact for the mentally ill. The purpose of the present study was to determine if a framework that uses structured professional judgment (SPJ) principles in the Emergency Department (ED) could predict violence within an inpatient unit. The Inpatient Violence Screening Tool (IPVST) SPJ framework was comprised of several pre-existing measures and four additional items culled from a literature review. These measures include the Brøset Violence Checklist (BVC; Almvik & Woods, 1998) and the Dynamic Appraisal of Situational Aggression (DASA-IV; Ogloff & Daffern, 2006a). A third short-term risk assessment, the McNiel Violence Checklist Revised (VSC and VSC-R; McNiel & Binder 1994), was coded based on files. Participants were 697 individuals who presented to the psychiatric ED at a general hospital and were interviewed by the Psychiatric Triage Nurses (PTNs). The follow-up sample was 207 patients who were subsequently admitted to an inpatient unit. The IPVST was completed by the PTNs after their interview; the VSC, VSC-R and outcome data were collected from files of the follow-up sample. The results of this study partially supported the use of the IPVST as a risk assessment framework in the ED to prevent inpatient violence. There was consistency in SPJ ratings amongst the majority of the PTNs. The IPVST total score and SPJ rating were significantly related to management strategies as well as significantly related to inpatient violence. The AUCs of the total scores of the IPVST and the individual measures were between .62-.65, except for the BVC, which was not a significant predictor of inpatient violence. The AUCs for the categorical risk rating of the BVC, DASA, VSC, and VSC-R were between .54-.64. Implications for risk assessment and management are discussed.

Antecedentes. La valoración del riesgo de violencia es un requisito fundamental en la toma de decisiones profesionales que implican prevenir, intervenir o informar sobre la conducta de las personas. El uso de herramientas estructuradas de evaluación del riesgo de violencia ha mostrado mejoría en la precisión de las evaluaciones basadas exclusivamente en el juicio clínico o en la pericia de un experto en contextos psiquiátricos, penitenciarios y jurídicos. Objetivo. Este estudio presenta los resultados de la primera encuesta sobre las prácticas profesionales asociadas al uso de herramientas de evaluación del riesgo de violencia en España. Materiales y métodos. La información fue recogida mediante la administración de una encuesta en internet que fue distribuida por correo electrónico a los miembros de organizaciones profesionales. Resultados. De manera similar a los contextos profesionales del resto del mundo, las escalas de psicopatía de Robert Hare (Psychopathy Checklist-Revised y Psychopathy Checklist: Screening Version) y el Historical-Clinical-Risk Management-20 encabezaron la lista de las herramientas más usadas tanto por elección personal como por requisito institucional. Conclusiones. Se ofrecen datos novedosos sobre la prevalencia de uso y la utilidad percibida de las herramientas estructuradas, así como sobre otras cuestiones relacionadas a las prácticas profesionales de evaluación del riesgo de violencia en España que pueden orientar tanto a los profesionales de contextos sanitarios, correccionales y forenses, como a los responsables de las instituciones en la elección de las herramientas a implementar para asistirlos en la toma de decisiones. Background. Violence risk assessment is a key requirement in professional decision making involving prevention, intervention or reporting on human behavior. The use of structured tools for violence risk assessment has shown to improve the accuracy of assessments based exclusively on clinical judgment or expertise in psychiatric, correctional and legal settings. Objectives. This study presents results of the first survey about professional practices associated with tools for violence risk assessment in Spain. Materials and methods. The information was collected by administering an online-based survey that was distributed by e-mail to members of professional organizations around the country. Results. As in professional contexts worldwide, the Robert Hare's psychopathy scales (Psychopathy Checklist-Revised and Psychopathy Checklist: Screening Version) and the Historical-Clinical-Risk Management-20 topped the list of the most used tools both by professional choice and institutional requirement. Conclusions. We provide novel data on the prevalence of use and the perceived utility of specific tools, as well as on other issues related to the professional practice of violence risk assessment in Spain, which can guide professional in the health care, correctional and forensic settings, as well as those responsible for decisions in institutions about choosing which tool to implement.

The stalking literature to date has not focused on assessing and managing the risk posed by stalkers. This study explored the validity of the Structured Professional Judgement (SPJ) model of risk assessment in ex-intimate partner stalking cases and whether victim vulnerability factors (VVFs) add to the validity of the SPJ model. Criminal justice and mental health professionals (N = 108) completed an on-line file-based stalking risk assessment. Participants we re randomly assigned a case history and to either the victim vulnerability condition or the non-victim vulnerability condition. Results provided evidence of components of the SPJ model (vis-à-vis risk management strategies). In addition, the results suggested participants found VVFs useful in the risk assessment process. However, the victim information did not influence the number of risk factors identified nor the intensity or quality of the total risk management strategies. Possible explanations for these findings and the implications for risk assessment are discussed.

The stalking literature to date has not focused on assessing and managing the risk posed by stalkers. This study explored the validity of the Structured Professional Judgement (SPJ) model of risk assessment in ex-intimate partner stalking cases and whether victim vulnerability factors (VVFs) add to the validity of the SPJ model. Criminal justice and mental health professionals (N = 108) completed an on-line file-based stalking risk assessment. Participants we re randomly assigned a case history and to either the victim vulnerability condition or the non-victim vulnerability condition. Results provided evidence of components of the SPJ model (vis-à-vis risk management strategies). In addition, the results suggested participants found VVFs useful in the risk assessment process. However, the victim information did not influence the number of risk factors identified nor the intensity or quality of the total risk management strategies. Possible explanations for these findings and the implications for risk assessment are discussed.