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Danger assessment tools

Dr Davina Kaur Patel talks about a domestic violence risk assessment tool used in the UK.
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So one of the problems that health care workers have previously encountered when they’ve met with a patient who has disclosed domestic violence is that its very difficult as a health care worker who doesn’t see many of these cases to assess the level of risk to both the patient and to any children that are involved. And so a tool that has emerged in recent years that health care workers are beginning to use in the UK is called the Domestic Violence Risk Assessment Tool.
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And this is a series of questions that the health care worker can sit down with a patient and go over and basically to help them create a score that will then give them an idea of the level of risk that that patient is facing. And the risk is usually low, medium, high risk and then immediate danger. Questions that the risk assessment tool includes are, for example, “Have you felt that your life is at threat?”, “Have any violent weapons been used towards you?” and several others.

Spend a few minutes watching this interview with Dr Davina Kaur Patel as she explains the domestic violence risk assessment tool used in the UK.

Several different tools are available for health workers to carry out danger assessments. The “DA-5” tool shown below contains five questions which are highly predictive risk factors for severe injury and homicide.

Danger Assessment Tool: This brief risk assessment identifies women who are at high risk for homicide or severe injury by an intimate partner. Mark "Yes" or "No" for each of the following questions. ("He" refers to your husband, partner, exhusband, ex-partner, or whoever is currently physically hurting you.) 1. Has the physical violence increased in frequency or over the past year? 2. Has he ever used a weapon against you or threatened you with a weapon? 3. Do you believe he is capable of killing you? 4. Does he ever try to choke you? 5. Is he violently and constantly jealous of you? Source: Campbell JC, 2004. Danger Assessment DA-5. Retrieved November 20, 2016

If the response to one or more of these questions is “yes”, we can consider our patient to be at risk. A more comprehensive tool (such as the danger assessment instrument, involving 20 questions) can subsequently be used to further assess the patient’s risk factors.

If the patient responds positively to four or five questions, immediate action is needed in order to avert serious threats to life and health.

Being concerned about the patient’s ongoing safety, you should refer her or him to appropriate services. In most countries, there is even a legal obligation for health professionals to report such cases to the police or the child protection services.

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Addressing Violence Through Patient Care
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