Decision Making about Dangerousness in Releasing Patients from Long-term Psychiatric Hospitalization

Abstract

This study examined mental health practitioners’ approaches to judging psychiatric inpatients’ dangerousness at the time of decision making about hospital discharge. Brief Psychiatric Rating Scale (BPRS) descriptions of 50 inpatients were studied in relation to four assessors’ evaluations of patients’ dangerousness and their recommendations regarding conditional release to an outpatient program. Judged dangerousness was well modeled by a multiple linear regression equation (R = .91) and was found positively correlated with 13 BPRS variables. Five BPRS scales associated with the recommendation to discharge patients were also identified. On two-year followup none of the patients released to the outpatient program was found to have committed a violent act. Results were compared with prior findings on mental health workers’ decision making about violence, and recommendations for future research were discussed.