Documentation of Violence Risk Information in Psychiatric Hospital Patient Charts: An
E. B. Elbogen, A. J. Tomkins, A. P. Pothuloori and M. J. Scalora,
Journal of the American Academy of Psychiatry and the Law
31(1): 058-064, 2003.
Studies have identified risk factors that show a strong association with violent behavior in psychiatric
populations. Yet, little research has been conducted on the documentation of violence risk
information in actual clinical practice, despite the relevance of such documentation to risk assessment
liability and to conducting effective risk management. In this study, the documentation of cues of risk
for violence were examined in psychiatric settings. Patient charts (n = 283) in four psychiatric
settings were reviewed for documentation of violence risk information summarized in the MacArthur
Violence Risk Assessment Study. The results revealed that particular patient and institutional
variables influenced documentation practices. The presence of personality disorder, for example,
predicted greater documentation of cues of violence risk, regardless of clinical setting. These findings
have medicolegal implications for risk assessment liability and clinical implications for optimizing risk
management in psychiatric practice.