Introduction of Risk for Violence Directed to Self and Others:
It is a critical aspect of mental health care. It is essential for providing comprehensive and
effective support to individuals struggling with mental health challenges.
Definition:
The term “risk for violence directed to self and others” refers to the potential for an individual to
engage in harmful or destructive behaviors that may pose a threat to their own well-being or the
safety of those around them.
In simple words “the chance that a person might harm themselves or other people.”
Literature Review on Mental Health and Mental Illness:
Several studies have found a strong correlation between mental illness and an increased risk of
violence, both towards oneself and towards others. Individuals with untreated or poorly managed
mental health conditions may experience delusions, hallucinations, or heightened emotional
states that can contribute to aggressive or violent behavior. Additionally, factors such as
substance abuse, social isolation, and lack of access to mental health resources can further
exacerbate the risk of violence in this population.
Research has shown that mental illness can have a profound impact on an individual’s well-
being, relationships, and overall quality of life. Disorders such as depression, anxiety,
schizophrenia, and bipolar disorder can lead to emotional distress, impaired cognitive
functioning, and difficulty in daily functioning.
Case Scenario from Psychiatric Unit:
The patient, a 35-year-old male diagnosed with Bipolar Disorder, had been admitted for a manic
episode. During his stay, the patient became increasingly agitated and verbally aggressive
towards the nursing staff. He would pace the unit, yelling and threatening to harm himself and
others if his demands were not met. The nursing team recognized the escalating risk and
immediately implemented a crisis intervention plan, including medication adjustments, one-on-
one supervision, and de-escalation techniques. Despite these efforts, the patient’s behavior
continued to deteriorate, leading the team to Initiate a 72-hour involuntary hold for further
assessment and stabilization. This case highlights the importance of vigilance, timely
intervention, and a multidisciplinary approach in managing patients with a high risk of violence
in the psychiatric setting.
Analysis of the Topic with Clinical Experience:
In my experience working in a psychiatric unit, I have encountered several cases where patients
presented with a high risk of violence directed towards themselves or others. One such scenario
involved a middle-aged male patient diagnosed with schizoaffective disorder. He had a history of
poor medication adherence and had recently experienced a manic episode, during which he
became increasingly agitated and verbally aggressive towards the nursing staff.
During our assessment, we identified several risk factors for violence, including a history of past
violent behavior, poor impulse control, and delusional beliefs that the staff were conspiring
against him. The patient’s erratic behavior and refusal to cooperate with treatment further
escalated the situation, and we had to implement a range of interventions to de-escalate the
situation and ensure the safety of both the patient and the staff.
Through this clinical experience, I gained a deeper understanding of the complex interplay
between mental illness, psychosocial factors, and the risk of violence. It highlighted the
importance of a comprehensive assessment, early intervention, and a multidisciplinary approach
to effectively manage and reduce the risk of violence in psychiatric settings.
Nursing Care Plan and Intervention to Reduce Risk:
1. Promote Safety and Security
2. Implement environmental safety measures such as removing potential weapons, ensuring
adequate lighting, and maintaining a calm and structured setting. Provide a secure and
supportive environment that helps the patient feel safe and cared for, reducing the
likelihood of violent behavior.
3. Therapeutic Communication
4. Engage the patient in open and empathetic dialogue, actively listening to their concerns
and validating their feelings. Use de-escalation techniques, such as speaking in a calm
and reassuring tone, to help the patient regain control and reduce the risk of violence.
5. Collaboration with the Multidisciplinary Tea
6. Work closely with the patient’s psychiatrist, psychologist, social worker, and other
healthcare providers to develop a comprehensive care plan. Share information, coordinate
interventions, and ensure a consistent approach to reducing the risk of violence.
7. Patient Education and Empowerment
8. Educate the patient on the importance of medication adherence, coping strategies, and
anger management techniques. Empower the patient to actively participate in their own
care and develop self-awareness, which can help them identify and manage triggers for
violent behavior.
Conclusion:
In conclusion, the issue of risk for violence directed towards self and others in the context of
mental health and mental illness is a complex and multifaceted challenge that requires a
comprehensive approach. Through the analysis of the case scenario and the integration of clinical
experience, it is clear that early identification, assessment, and tailored interventions are crucial
to mitigating this risk and promoting the well-being of both the individual and the community.
References:
Appelbaum, P. S. (2013). Public safety, mental disorders, and guns. JAMA Psychiatry, 70(6),
565–566. [invalid URL removed]
Singh, J. P., Bjørkly, S., & Fazel, S. (Eds.) (2016). International perspectives on violence risk
assessment. New York: Oxford University Press.
