Beyond Prediction: Supporting Clinical Decision Making in the Prevention of Aggression in a Forensic Mental Health Setting

Aggression is a serious problem in mental health units, and prevention and containment efforts often rely upon restrictive interventions which have the potential to cause harm. Preventing aggression without use of restrictive practices requires routine accurate risk assessment accompanied by appropriate, timely, interventions. This study tested an electronic Clinical Decision Support System incorporating the Dynamic Appraisal of Situational Aggression and an Aggression Prevention Protocol (eDASA+APP) in two acute forensic mental health units for men. Implementation was associated with a significant reduction in the odds of the occurrence of aggressive incidents and a significant decrease in the odds of restrictive practices being used.