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Use of a violence risk prediction tool (Oxford Mental Illness and Violence) in early intervention in psychosis services: mixed methods study of acceptability, feasibility and clinical role

Abstract:

Background: Scalable assessment tools for precision psychiatry are of increasing clinical interest. One clinical risk assessment that might be improved by such approaches is assessment of violence perpetration risk. This is an important adverse outcome to reduce for some people presenting to services for first-episode psychosis. A prediction tool (Oxford Mental Illness and Violence (OxMIV)) has been externally validated in these services, but clinical acceptability and role need to be examined and developed.

Aims: This study aimed to understand clinical use of the OxMIV tool to support violence risk management in early intervention in psychosis services in terms of acceptability to clinicians, patients and carers, practical feasibility, perceived utility, impact and role.

Method: A mixed methods approach integrated quantitative data on utility and patterns of use of the OxMIV tool over 12 months in two services with qualitative data from interviews of 20 clinicians and 12 patients and carers.

Results: The OxMIV tool was used 141 times, mostly in new assessments. Required information was available, with only family history items scored unknown to any notable degree. The OxMIV tool was deemed helpful by clinicians in most cases, especially if there were previous risk concerns. It was acceptable practically, and broadly for the service, for which its concordance with clinical judgement was important. Patients and carers thought it could improve openness. There was some limited impact on plans for clinical support.

Conclusions: The OxMIV tool met an identified clinical need to support clinical assessment for violence risk. Linkage to intervention pathways is a research priority.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1192/bjp.2024.293

Authors

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Role:
Author
ORCID:
0000-0001-5323-364X
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0001-8029-1052
More by this author
Role:
Author
ORCID:
0000-0002-0596-8200
More by this author
Role:
Author
ORCID:
0000-0002-0348-6195
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Oxford college:
All Souls College
Role:
Author
ORCID:
0000-0002-4972-8786


Publisher:
Cambridge University Press
Journal:
British Journal of Psychiatry More from this journal
Volume:
228
Issue:
2
Pages:
140-149
Publication date:
2025-03-20
Acceptance date:
2024-11-28
DOI:
EISSN:
1472-1465
ISSN:
0007-1250


Language:
English
Keywords:
Pubs id:
2096531
Local pid:
pubs:2096531
Deposit date:
2025-03-21
ARK identifier:

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