Self Perceptions of Risk

Policy makers and citizens are concerned about the adequacy of violence risk assessment and treatment services for people with mental illness. Although risk assessment instruments could help identify the small group of high risk people, these instruments are rarely used in clinical settings because they require hours to complete and divert scarce resources from treatment.

In an NIH-funded study, we are examining an innovative and clinically feasible method for assessing patients' risk. Our model shifts focus from clinical prediction to patients' self-prediction, given that patients have a lifetime of experience in a wide variety of situations. We find that patients predict their own involvement in self harm and violence as accurately as risk assessment tools -- and better than clinicians. Self prediction holds considerable promise as a feasible method for partnering with patients in efforts to prevent violence and improve healthy outcomes. We intend to test this promise directly in an upcoming clinical trial.