Violence Risk Assessment for Young Adults Receiving Treatment for Early Psychosis

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Amplify OnTrackNY publication summaries summarize peer-reviewed publications focused on quality improvement or research conducted to help us learn & improve the program.

Study snapshot

Young people experiencing psychosis have an increased risk of violence compared to people without psychosis, though the overall risk of violence is low. This study examined the use of a structured tool, the HCR-20, to assess the risk of engaging in violence among youth with early psychosis.¹  

This study asks:

1. Is it possible to use a structured tool called the Historical Clinical Risk Management-20 (HCR-20) to assess future risk of violence in a setting like OnTrackNY?
2. What are the key factors that contribute to risk of future violence?

The HCR-20 includes a list of potential factors that may be associated with risk of violence. A clinician used information from participant medical records to rate the degree to which different risk factors on the HCR-20 (such as previous violence, substance use, lack of personal support) were present for each participant.

Figure 1: Who participated in this study?

This study is based on 53 OnTrackNY participants from diverse backgrounds.

Study findings

Finding 1. It is possible to assess violence risk among individuals with early psychosis using a tool called the HCR-20.

Finding 2. Most participants were at low risk for future violence (see Figure 2).

Finding 3. Risk of violence was most highly associated with having thoughts or intentions about harming others and a history of antisocial behavior.

Finding 4. Risk of violence was not associated with a history of substance use, history of serious mental health challenges, living situation, or personal support.

Figure 2: Violence risk was low for most participants

Final thoughts

Most people experiencing early psychosis have a low risk of violence. Using a risk assessment tool in programs like OnTrackNY may help prevent a first episode of violence and support participants and families in recognizing conflicts to promote positive relationships and recovery.

References

1. Rolin SA, Bareis N, Bradford JM, Rotter M, Rosenfeld B, Pauselli L, Compton MT, Stroup TS, Appelbaum PS, Dixon LB. Violence risk assessment for young adults receiving treatment for early psychosis. International Journal of Law and Psychiatry. 2021 April; 76. doi: 10.1016/j.ijlp.2021.101701. Epub 2021 April 19. PMID: 33887604.

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