VIOLENCE IN THE MENTALLY ILL--COLLATERAL INFORMANTS

本建议利用风险提供的独特机会

This proposal capitalizes upon a unique opportunity provided by the Risk Assessment Study funded by the John D. and Catherine T. MacArthur Foundation. The Risk Assessment Study is investigating the prevalence of, and key factors related to, violence by discharged mental patients living in the community. A sample of 1,000 persons who reside on acute inpatient psychiatric units at three sites (Worcester, Massachusetts; Pittsburgh; and Kansas City) will be interviewed during their first week of admission and then followed after release for a series of five interviews over a one-year period. This application seeks to add a potentially crucial source of information about the occurrence of community violence by the subjects: the reports of "collateral" informants, typically family members, who often are in unique positions to observe the patient. Funds are requested to interview one collateral for each of the 1,000 released patients in the Risk Assessment Study. Each collateral will be interviewed at the same intervals as Risk Assessment Study subjects (five times over one year) to obtain data on the subject's violent behavior, the circumstances associated with it, the subject's levels of functioning, and the subject's social support networks. Collateral reports will be combined with subject self-report data and with arrest and hospitalization records to assess the relationships between key variables often used by clinicians in risk assessment and actual violent behavior in the community. The proposed study would permit the most complete characterization to date of violent behavior by former mental patients in the community. It would have important implications for both risk assessment and risk management. By combining collateral reports with information from the three MacArthur-supported sources -- self-report, arrest records, and hospital records -- we will have a criterion variable sensitive enough to validate a wide range of risk factors for the occurrence of violence.