Developing a treatment pathway to reduce violence risk in psychosis: from risk assessment to complex intervention
Abstract
Violence perpetration is an important adverse outcome for psychiatric services to reduce. Clinical services for psychosis, such as Early Intervention in Psychosis services, represent a key opportunity for prevention, but this is challenging without specialist expertise and resource for violence risk assessment and management. One innovation to address this is a scalable clinical prediction tool for violence, OxMIV, which has been developed using contemporary statistical approaches and been found to be both feasible to use and more accurate than clinical judgement alone in these settings. However, assessing risk does not reduce violence unless it leads to effective interventions being offered more consistently to those who are most likely to benefit. Evidence-based, population health approaches for linking individual risk estimates to intervention pathways have been successfully implemented elsewhere in medicine. Here we adopt such an approach for assessing and reducing the risk of violence in psychosis, presenting a framework for using OxMIV to support decision-making around allocating resources for further assessment and offering interventions that address modifiable risk factors. To develop, implement and test the effectiveness of such clinical pathways, assessments of risk and linked interventions should be studied together as complex healthcare interventions.
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BibTeX
@misc{whiting2026developing,
title = {{Developing a treatment pathway to reduce violence risk in psychosis: from risk assessment to complex intervention}},
author = {Daniel Whiting and Belinda Lennox and Seena Fazel},
howpublished = {PsyArXiv},
year = {2026},
month = sep,
doi = {10.31234/osf.io/nprjk_v2},
url = {https://osf.io/preprints/psyarxiv/nprjk_v2/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Developing a treatment pathway to reduce violence risk in psychosis: from risk assessment to complex intervention
AU - Daniel Whiting
AU - Belinda Lennox
AU - Seena Fazel
PY - 2026
DA - 2026/09/19
PB - PsyArXiv
DO - 10.31234/osf.io/nprjk_v2
UR - https://osf.io/preprints/psyarxiv/nprjk_v2/
AB - Violence perpetration is an important adverse outcome for psychiatric services to reduce. Clinical services for psychosis, such as Early Intervention in Psychosis services, represent a key opportunity for prevention, but this is challenging without specialist expertise and resource for violence risk assessment and management. One innovation to address this is a scalable clinical prediction tool for violence, OxMIV, which has been developed using contemporary statistical approaches and been found to be both feasible to use and more accurate than clinical judgement alone in these settings. However, assessing risk does not reduce violence unless it leads to effective interventions being offered more consistently to those who are most likely to benefit. Evidence-based, population health approaches for linking individual risk estimates to intervention pathways have been successfully implemented elsewhere in medicine. Here we adopt such an approach for assessing and reducing the risk of violence in psychosis, presenting a framework for using OxMIV to support decision-making around allocating resources for further assessment and offering interventions that address modifiable risk factors. To develop, implement and test the effectiveness of such clinical pathways, assessments of risk and linked interventions should be studied together as complex healthcare interventions.
ER -