Dynamic Risk Factors in Serious Mental Illness Cases

Stephan M. Carlson, MD, MBA, FAPA · Violence and Threat Risk

Static history—a prior conviction, a fixed diagnosis, an age at first arrest—cannot be changed by any intervention, so it tells a court what happened but little about what to do next. The forensic weight of a serious-mental-illness risk opinion lives in the dynamic factors: the symptoms, substances, adherence, and supervision that a disposition can actually touch. What "dynamic" means and why it changes the legal question Risk factors divide into two families. Static factors are historical and fixed: age at first violent act, prior incarcerations, a chronic diagnosis. Dynamic factors are clinical states that fluctuate and can be targeted—active psychotic symptoms, intoxication, treatment non

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