Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 4, pp 627–637

Predicting community violence from patients discharged from acute mental health units in England

  • Michael Doyle
  • Stuart Carter
  • Jenny Shaw
  • Mairead Dolan
Original Paper

DOI: 10.1007/s00127-011-0366-8

Cite this article as:
Doyle, M., Carter, S., Shaw, J. et al. Soc Psychiatry Psychiatr Epidemiol (2012) 47: 627. doi:10.1007/s00127-011-0366-8



To investigate the validity of risk factors and established risk measures in predicting community violence in an acute mental health sample up to 20 weeks post-discharge.


Prospective cohort follow-up study conducted between January 2006 and August 2007. Baseline assessments were conducted while participants were inpatients. The measures were rated following interview with the participants, record review and speaking to someone who knows the person well (e.g. friend, relative, carer). Baseline measures were then compared with frequency and severity of violence in the community post-discharge at 20 weeks.


In the 20-week period post-discharge, 29 (25.4%) of the 114 participants were violent. All the risk measures and measures of impulsiveness and anger were predictive of violence where p < 0.05. The HCR-20 total, psychopathy and clinical factors were strongly correlated with the frequency of violence where p < 0.05.


The risk factors and risk measures that have been found to be predictive in forensic samples are also predictive in acute mental health samples, although the effects are not as large. Future research needs to be conducted with a larger sample to include investigation of differences in risk factors based on gender and social support. Services and clinicians need to consider how to integrate findings into useful frameworks to support decisions and contribute to managing risk. This should assist in identifying interventions aimed at preventing community violence.


ViolenceRisk assessmentAcute psychiatryCommunity

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Michael Doyle
    • 1
  • Stuart Carter
    • 2
  • Jenny Shaw
    • 3
  • Mairead Dolan
    • 4
  1. 1.Community Based Medicine, Adult Forensic Mental Health Services, Greater Manchester West NHS Mental Health Foundation TrustUniversity of ManchesterManchesterUK
  2. 2.Bolton Primary Care Mental Health Service, Bolton Primary Care TrustBoltonUK
  3. 3.Department of Psychiatry, Lancashire Care NHS TrustUniversity of ManchesterManchesterUK
  4. 4.Centre for Forensic Behavioural ScienceMonash UniversityClaytonAustralia