LETHALITY ASSESSMENT

USING

THE

LETHALITY SCREEN AS PART OF THE

LETHALITY ASSESSMENT PROGRAM

Melissa McCurry
June 16, 2016

Definitions
&
Abbreviations
Lethality Screen (LS): a brief 11-item questionnaire meant to assess
the probability of homicide by an abusive romantic partner
Lethality Assessment Program (LAP): a collaboration between police
and social service providers consisting of the following 2 steps: 1) a
police officer responding to the scene of a domestic violence incident
uses the LS to identify victims at high risk of homicide and 2) any
victim that screens in as high risk based on the LS is put in immediate
telephone contact with a collaborating social service provider who
provides them with advocacy, safety planning and referral for services
Domestic Violence (DV)
Interpersonal Violence (IPV)

The Lethality Screen and Lethality Assessment

Program was born from research originally conducted
by Jacquelyn Campbell, creator of the original Danger
Assessment Tool.
As of 2015, jurisdictions in 34 states have
adopted the LS for use as part of a larger LAP
protocol.

Domestic Violence Lethality

Screen For First Responders
Officer:

Date:

Victim:

Offender:

Case:

Check here if victim did not answer any of the questions.

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.

A "Yes" response to any of Questions #1-3 automatically triggers the protocol referral.
Has he/she ever used a weapon against you or threatened you with a weapon?
Yes
No
Not Ans.
Has he/she threatened to kill you or your children?
Yes
No
Not Ans.
Yes
No
Not Ans.
Do you think he/she might try to kill you?
Negative responses to Questions #1-3, but positive responses to at least four of Questions #4-11, trigger the protocol referral.
Does he/she have a gun or can he/she get one easily?
Yes
No
Not Ans.
Has he/she ever tried to choke you?
Yes
No
Not Ans.
Is he/she violently or constantly jealous or does he/she control most of your daily activities?
Yes
No
Not Ans.
Have you left him/her or separated after living together or being married?
Yes
No
Not Ans.
Yes
No
Not Ans.
Is he/she unemployed?
Has he/she ever tried to kill himself/herself?
Yes
No
Not Ans.
Do you have a child that he/she knows is not his/hers?
Yes
No
Not Ans.
Yes
No
Not Ans.
Does he/she follow or spy on you or leave threatening messages?
An officer may trigger the protocol referral, if not already triggered above, as a result of the victim's response to the below question,
or whenever the officer believes the victim is in a potentially lethal situation.
Is there anything else that worries you about your safety? (If "yes") What worries you?

Check one:

Victim screened in according to the protocol

Victim screened in based on the belief of officer
Victim did not screen in

If victim screened in: After advising her/him of a high danger assessment, did the victim speak with the hotline counselor?
Yes
No
Note: The questions above and the criteria for determining the level of risk a person faces is based on the best available research on factors associated with lethal
violence by a current or former intimate partner. However, each situation may present unique factors that influence risk for lethal violence that are not captured by this
screen. Although most victims who screen positive or high danger would not be expected to be killed, these victims face much higher risk than that of other victims of
intimate partner violence.
MNADV 08/2005

The screen is
administered
on scene by the
first responder.
Answers
are provided to
the advocate by
phone before
passing the call to
the victim.
If screened into
the program most
shelters keep
several beds
available for LAP
clients only.

Strengths
Sensitivity is maximized because this
is the first risk assessment which
asks questions only of the victim
(Messing et.al, 2015)
Scoring system is designed for ease
of use with results as high danger
or not high danger
92.86% sensitivity in predicting near
fatal violence in study by Messing et
al (2015)

Limitations

High incidence of false positives when

predicting severe IPV after LAP
screening (Messing, et. al, 2015)
Research is limited into effectiveness
of screen
Research suggests women of color will
not disclose information to complete
LS. (Campbell et. al, 2007)
LS uses lethality indicators which
are hallmarks of any abusive
relationships
There is little to no ability to
standardize information gathered in
order to predict lethality

CULTURAL
CONSIDERATIONS
Women of color call law enforcement less
frequently and are less likely to consent to the
LS (Campbell, 2004)
Research suggests that class, income, and
employment are better indicators than race
for future lethality (Messing et al, 2015)

Important Ethical & Legal

Considerations
The LS is often used in proceedings to issue protective orders
and custody rulings, despite the inability to predict lethality
with 100% accuracy. (Messing, et. al, 2015)

Clinicians should never advise a client to leave an abusive

situation without a safety plan and resource referrals in place,

despite ethical motivations (Kress, et al, 2008)

Ethically counselors are compelled to empower client decision

making. To push her to leave may disempower her. (Kress, et al,

2008)

Assessments made on clinical information often overestimate

risk (Haggard-Grann, 2007)

Implications for Field Work

Know how to prepare your client in the event they

need to involve law enforcement; or how to debrief

after a LS may have been administered

Make your client aware of resources in the

community which should always include DV shelters

and agencies that can assist with safety planning
and acquiring a protection order

Victims of IPV typically present with issues

including, but not limited to, depression, anxiety,

suicide, and PTSD

Controlling behaviors and jealousy are indicators of

IPV, you may be working with a perpetrator

Resources

Campbell, J. (2005). Commentary on Websdale: Lethality assessment approaches: reflections on

their use and ways forward. Violence Against Women , 11 (9), 1206-1213.

Campbell, J. (2004). Helping women understand their risk in situations of intimate partner
violence. Journal of Interpersonal Violence , 19 (12), 1464-1477.

Campbell, J., Glass, N., Sharps, P., Laughon, K., & and Bloom, T. (2007). Intimate partner
homicide: Review and implications of research and policy. Trauma, Violence, and Abuse , 8, 256269.

Campbell, J., Webster, D., & and Glass, N. (2009). The danger assessment: Validation of a
lethality risk assessment instrument for intimate partner femicide. Journal of Interpersonal
Violence , 24 (4), 653-674.

Haggard-Grann, U. (2007). Assessing violence risk: A review and clinical recommendations.

Journal of Counseling and Development , 294-301.

Kress, V., Protivnak, J., & and Sadlack, L. (2008, July). Counseling clients involved with violent
intimate partners: The mental health counselor's role in promoting client safety. Journal of Mental
Health Counseling , 200-210.

Messing, J., Campbell, J., Wilson, J., Brown, S., & and Patchell, B. (2015, May 11). The lethality
screen: The predictive validity of an intimate patrner violence risk assessment for use by first
responders. Journal of Interpersonal Violence , 1-22.

Websdale, N. (2000, February). Lethality assessment tools: A critical analysis. Retrieved

06/15/2016, from: http://www.vawnet.org