Psychiatric Risk Assessment Scale (PRAS)

Abstract

Introduction

The aim of psychiatry is the prediction of risks.

Objectives

Creation of the Psychiatric Risk Assessment Scale (PRAS) (Table 1).

Aims

To assess psychiatric inpatients for risk to self and others.

Methods

The PRAS comprises 20 risk items that rate five probabilities of occurrence: 0% (nil), 25% (low), 50% (moderate), 75% (high) and 100% (severe). Cut-off score indicates “moderate” risk = 50. The mathematical formulas for the risks are as follows:

– severity of risk (SR) = average for the whole table multiplied by %;

– number of significant risk events (NSRE) = count of risks scored from 50% to 100% divided by 20 (items);

– probability of occurrence of risks (POR = NSRE%);

– range probability of death (RPD) = range score of (overdose + suicide + reckless activities)%.

Two raters assessed independently n = 8 patients. Kappa inter-rater statistic was used by dichotomous results (above-below cut-off score).

Results

Inter-rater Kappa = 0.60 indicates a moderate inter-rater agreement. In the sample, only 2 patients scored above the cut-off score of 50, indicating a level of moderate-to-severe risk. For the other patients, the average SR = 36%, indicating low-to-moderate risk.

Conclusions

PRAS is constantly used to assess the likelihood that the care provided to patients admitted to hospital is sufficient or whether major remedial action is required.

Table 1

Disclosure of interest

The authors have not supplied their declaration of competing interest.