ABSTRACT
The government commissioned report which laid the foundations for modern forensic psychiatry in the UK used the term ‘dangerousness’, but it is rarely used in clinical practice. Concern about use of the word ‘dangerousness’ is partly because it is so widely used, has more than one application and is not value free. In 1993, the National Health Service Executive offered a useful template from a management perspective, which remains valid. Identification of the possibility of risk is a necessary precursor to its assessment. The Violence Risk Assessment Guide (VRAG) is designed to predict violence and is probably the most widely tested and researched actuarial instrument. Studies of the VRAG cited schizophrenia as a protective factor against violence, but most patients in forensic mental health services in the UK, and many other countries too, have a schizophrenic illness. Violence risk assessment is widely assumed by policy makers and the public to be a core skill of the mental health professions.
