Richard: Very interesting question, there are a lot of factors that contribute to poor health and poor mental health, some of which include poverty, social exclusion, drugs, unemployment and access and or availability of community resources/healthcare. We are much better at early intervention, however austerity has had a detrimental impact, with increase in homelessness and the use of food banks, health, whether its physical or mental health is as much a societal problem and the solution of which is in the hands of those individuals we vote into government, we all have a vote….
Like Richard says there are lots of factors that underly violence, some of which we can try and sort out if we know about it (e.g. supporting someone to stop using drugs), some of which we can’t (e.g. a history of violence within the family growing up). I think in an ideal world all services would be better at communicating, for example social services could let mental health teams/CAMHS know if people are at risk, then we could get involved and support people much earlier if they need help with their mental health. This happens in some places but sadly not everywhere. There are for example, anger management classes that people could benefit from.
Essentially it stems down to looking at the whole person – think of it this way: a child has only ever been shown violence to solve problems as their family was abusive growing up. They then learn this behaviour and it is difficult to shake as it’s all they’ve ever known. They may or may not develop mental health problems, they may live in deprived areas and in poverty, they might take drugs because this makes them feel better. Whilst risk is important, if we look at the person as a whole and try and understand why violence occurs we can hopefully get better at treating the root causes of it and preventing it, rather than waiting and reacting when someone is violent instead.
The best you can do is to get a good history (meaning asking them to give a detailed story of their life) and asking others who know the person well about them as well. If they have been violent in the past, this increases the risk of them being violent in the future. Some things increase or decrease the risk and doing ‘risk assessments’ are our current best way of guessing if they will be violent, but it is still an educated guess. No one can predict will 100% if anyone will be violent or not. To prevent it you can keep people in a secure hospital (if they are deemed a high risk or very likely to be violent). You have to be careful though. You could end up locking people up who would never be violent again . Also there are no ‘violent disorders’ as such, but there are things people can do which increases their risks of bing violent like doing drugs or alcohol.
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