Avoiding negligent release: contemporary clinical and risk management strategies

Risk communication of terrorist acts, natural disasters, and criminal violence: comparing the processes of understanding and responding

Risk communication is an important vehicle for the scientific understanding of the perception of and response to various kinds of threats. The present study provides apparently the first empirical attempt to compare perceptions, decision-making, and anticipated action in response to threats of three kinds: natural disaster, violent crime, and terrorism. A total of 258 college undergraduates were surveyed using a vignette-based, 2 × 2 × 3 between-subjects design that systematically manipulated threat imminence (high vs. low), risk level (high vs. low), and nature of the threat (natural disaster vs. crime vs. terrorism). There were substantial differences in participants' perceptions and reported actions in response to natural disaster, relative to the other domains of risk, under conditions of high risk. The risk of natural disaster was more likely to lead participants to report that they would change their daily activities and to relocate. It was also more likely than terrorism to lead to action securing the home. It appears that the mechanisms for perception, decision-making, and action in response to threats cannot be generalized in a straightforward way across these domains of threat.

A community meeting protocol for assault prevention

Assaultive behavior by patients is a serious problem throughout healthcare facilities. Currently, wide variability exists in the approaches used to deal with assaultive behavior. The immediate objective of this study was to perform a consensus validation of the community meeting as a prevention and intervention measure for assault. The community meeting is a regular meeting of all staff and patients for communication, ward management, or psychiatric treatment. A delphi survey, with three iterations, was used to operationalize the collection of judgments and achieve convergence of opinion from expert respondents. A protocol for a Violence Prevention Community Meeting (VPCM) was established.

Legal issues in maximum security institutions for people with mental illness: liberty, security, and administrative discretion

This article explores four legal issues relevant to the provision of care in secure hospitals. These include the current status of right to treatment litigation; the potential impact of the Americans with Disabilities Act; new developments in laws governing restraint and seclusion; and the need for uniform institutional policies on risk assessment. These issues illustrate the potential conflicts between individual autonomy and institutional control that have been at the heart of mental health law for three decades. The article suggests that because of the diminishing oversight provided by the federal judiciary, institutional custodians have a particular obligation to ensure that individual rights are not overwhelmed by concerns with security.