Development and testing of procedures for violence screening and suicide risk stratification on a psychiatric emergency service

Objective The objective was to examine the relationship between violence screening items, suicide risk stratification, and disposition in a psychiatric emergency service setting. Methods A retrospective review of electronic health record data for 286 patient encounters was performed. Results Four of the 6 violence risk screening items were significantly associated with both involuntary presentation to the psychiatric emergency service and high-risk stratification. These 4 items were also associated with psychiatric hospital disposition in bivariate analysis, however, only indirectly through their association with high-risk stratification, which in turn was directly associated with psychiatric hospital disposition. Conclusion Violence screening items inform disposition but only through the use of risk stratification, supporting the need for additional research into the predictive value of standardized suicide risk stratification definitions to inform clinical practice.