The START is a 1-page structured professional judgment instrument that guides the comprehensive assessment of short-term risk for 7 adverse outcomes: violence to others, suicide, self-harm, victimization, substance abuse, unauthorized absences/breach of conditions, and self-neglect. START includes 20 dynamic risk and protective factors, as well as therapeutic levers and ‘red flag’ issues to be monitored and targeted through risk management and treatment. Research demonstrates that START has good reliability, validity, and user satisfaction. The manual has been translated into 9 languages and is being used all over the world.
START has been identified as a best practice for the assessment and management of violence and related risks, a promising practice for the assessment of inpatient aggression, and a leading practice in mental health services.