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Decision Making About Dangerousness in Releasing Patients From Long-Term Psychiatric Hospitalization

NCJ Number
149996
Journal
Journal of Psychiatry and Law Volume: 20 Issue: 1 Dated: (Spring 1992) Pages: 35-48
Author(s)
P D Werner; J R Meloy
Date Published
1992
Length
14 pages
Annotation
This study examined mental health practitioners' approaches to judging psychiatric inpatients' dangerousness at the time of decisionmaking about hospital discharge.
Abstract
Subjects were 50 consecutive State hospital inpatients under review for placement in a "conditional release" involuntary outpatient program. All patients had been acquitted as "not guilty by reason of insanity." Evaluations were administered in 1986 and 1987, and all subjects had been hospitalized for at least 2 years at the time of evaluation. Each patient underwent a clinical interview with two experienced clinical staff members, the goal of which was to determine eligibility for the conditional release program. Following the interview, the staff members described the patient by means of the scales of the forensic adaptation of the Brief Psychiatric Rating Scale (BPRS), rated the patient's dangerousness with a seven-point scale of risk to persons, and recommended to the local superior court acceptance or rejection from the program. Using a multiple linear regression equation (R=.91), the judgment of "dangerous" was found to be positively correlated with 13 BPRS variables. Five BPRS scales associated with the discharge recommendation were also identified. A 2-year followup found that none of the patients released to the outpatient program had committed a violent act. Results are compared with prior findings on mental health workers' decisionmaking about violence, and recommendations for future research are discussed. 2 tables and 23 notes

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