hardviolence riskemergency psychiatrystructured professional judgmentHCR-20risk assessment
A 32-year-old male is brought to the psychiatric emergency department by law enforcement after threatening his neighbor with a knife. He has a history of antisocial personality disorder, polysubstance use disorder, and two prior arrests for assault. He is currently intoxicated with alcohol (BAL 0.22 g/dL). On interview, he is irritable but cooperative, denies intent to harm anyone, and states, 'He had it coming but I'm done now.' He denies auditory hallucinations or command hallucinations. The PMHNP is conducting a structured violence risk assessment. Which assessment approach provides the most comprehensive and evidence-based evaluation of this patient's violence risk?