The assessment and management of risk of physical violence toward others posed by adults with a mental health condition in non-forensic health care settings: a scoping review.

Title: The assessment and management of risk of physical violence toward others posed by adults with a mental health condition in non-forensic health care settings: a scoping review. There is public concern about the risk of harm to others as a result of violence posed by adults with mental health conditions. Although most people with a mental health condition will not be violent towards others in their lifetime, there is some evidence that some mental health conditions are associated with a higher risk of violence, resulting in harm to others, compared with people without a mental health condition. Early identification of a potential need to intervene to prevent increased risk of harm as a result of mental health conditions may decrease unwanted outcomes such as violence to potential victims (others). UK guidelines have been produced for use in forensic healthcare settings. However, there are currently no UK guidelines relating to the assessment and/or management of risk (or threat) of violence by people with mental health conditions within non-forensic healthcare settings. Our aim is to identify research literature which can inform the development of clinical guidelines on the assessment and management of risk of interpersonal physical violence posed by adults with mental health conditions in non-forensic healthcare settings. In order to best inform the guideline development, we will collate research literature using scoping review methods. The scoping review is aimed at bringing together research studies focused on (i) assessing, clinically, the risk such adults pose of interpersonal physical violence both in the healthcare setting and external to that setting, and (ii) managing the risk of physical violence to others. The review will include systematic reviews and primary research studies published in English, focusing on adults over 18 years in non-forensic settings, including mental health and autism teams or services. We will search the Cochrane Library, Medline, Embase, CINAHL, and PsycInfo for studies published since 2016. We will include studies that explore the development and validation of assessment tools, identification of risk factors, management strategies to mitigate the risk/threats of or actual inter-personal physical violence, and studies exploring experiences relating to inter-personal physical violence perpetrated by a person with a mental health condition. This scoping review will collate all relevant research to allow an accurate overview of the current evidence base to enable development of meaningful guidance on assessment and management of risk of interpersonal physical violence for general mental health services. This study is funded by the NIHR Evidence Synthesis Programme (NIHR153425; NIHR178016).