Qualification Level: A
Purpose: Estimate violence risk after discharge in patients ages 18-60 years
Age: 18-60 Year Olds
Time: Approximatley 10 Minutes
The COVR is an interactive software programme designed to estimate the risk of an acute civil psychiatric patient becoming violent to others over the several months after discharge into the community. The programme guides the evaluator through a brief chart review and a 10-minute interview with the patient. The COVR then generates a report that contains a statistically valid estimate of the patient's violence risk, including the confidence interval for that estimate and a list of the questions used to produce the estimate.
Because a number of variables might be potential risk factors for violence among people with a mental disorder, the authors assessed personal factors (e.g., demographic and personality variables), historical factors (e.g., past violence, mental hospitalisations), contextual factors (e.g., social support, social networks), and clinical factors (e.g., diagnosis, specific symptoms). Patients in acute psychiatric facilities (N = 1,136) were assessed on 106 potential risk factors for violent behaviour and were followed for 20 weeks in the community after discharge from the hospital.
The COVR is based on a "classification tree" method. A classification tree approach prioritises an interactive and contingent model of violence--one that allows many different combinations of risk factors to classify an individual at a given level of risk. Each assessment is individualised; the particular questions asked depend on the answers given to prior questions. This approach contrasts with a regression approach in which a common set of questions is asked of everyone being assessed and every answer is weighted to produce a score that can be used for purposes of categorisation.
The programme was designed to be administered to individuals ages 18-60 years from a wide variety of racial/ethnic backgrounds and psychiatric diagnoses.