Integration of nomothetic and ideographic positions in risk assessment: Implications for practice and the education of psychologists and other mental health professionals.

1997 ◽  
Vol 52 (11) ◽  
pp. 1245-1246 ◽  
Author(s):  
Christopher D. Webster ◽  
David Cox
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals

How do mental health professionals deal with uncertainty in suicide risk assessment?

2011 ◽  
Vol 26 (S2) ◽  
pp. 1628-1628
Author(s):  
K. Manley ◽  
J. Beezhold
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Suicide Risk ◽  
List Type ◽  
Suicide Risk Assessment ◽  
Individual Level ◽  
Clinical Scenarios ◽  
Image Position

IntroductionSuicide risk-assessment forms a significant part of the workload of mental health professionals (MHPs). There is much research regarding efficacy of different methods/scales of suicide risk-assessment, and effects of formal training on risk-assessment. To date, there is little investigation into how approach to risk-assessment varies amongst professionals on an individual level, or how MHPs react when confronted by lack of information.ObjectiveThis study evaluated how MHPs respond to uncertainty when assessing suicide risk.Methods720 MHPs were given 10 clinical scenarios and asked to assess suicide risk in each case. The scenarios were a mixture of high, medium and low risk cases. In addition, there were scenarios where information provided was incomplete or ambiguous. Subjects graded suicide risk-severity from 1–10 (1 = low, 10 = high).ResultsThe simple scenarios produced a predictable consensus of opinion amongst MHPs. The ambiguous scenario produced three distinct response peaks (Fig. 1) at low, medium, and high risk.Fig. 1[Fig 1]ConclusionsAmbiguous suicide risk separates MHPs into three responder groups:1.‘don’t know’2.more cautious, assumes higher risk3.less cautious, assumes lower risk.This has implications for suicide risk training. Further research is required to fully understand why individuals respond in different ways to suicide risk scenarios.

Mental Health Professionals' Suicide Risk Assessment and Management Practices

Crisis ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Jared F. Roush ◽  
Sarah L. Brown ◽  
Danielle R. Jahn ◽  
Sean M. Mitchell ◽  
Nathanael J. Taylor ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Suicide Risk ◽  
Management Practices ◽  
Self Report ◽  
Evidence Based ◽  
Suicide Risk Assessment ◽  
Risk Assessment And Management

Abstract. Background: Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. Aims: The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Method: Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Results: Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. Limitations: The study utilized a cross-sectional design and self-report questionnaires. Conclusion: Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

Assessing and managing the risks of violence towards others

2012 ◽  
pp. 1991-2002 ◽  
Author(s):  
Paul E. Mullen ◽  
James R. P. Ogloff
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Criminal Justice ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Practice ◽  
Mental Health Practice ◽  
Individual Outcomes ◽  
Wide Range ◽  
Management Of Risk

Assessing and managing the risk of our patients being violent towards others now occupies a prominent position in virtually all forms of mental health practice, but it remains a contentious area. At the highest level researchers, psychometricians, and statisticians argue about almost every aspect, even whether anything useful can be said about individual outcomes rather than group indicators. At the next level an industry flourishes of selling training, and risk assessment tinstruments, to those who then appear as experts in a wide range of mental health and criminal justice contexts. On the ground, almost everyone in mental health is drawn into filling out purpose-designed forms and complying with protocols, most of little or no demonstrated validity. This chapter is intended to make clinicians aware of both the possibilities and limitations of existing approaches to the assessments of risk. Given that there is no reason for mental health professionals to evaluate risk without gaining information to manage it, this chapter will also address the management of risk for aggression and violence.

Don't Confuse me with the Facts

1999 ◽  
Vol 26 (1) ◽  
pp. 20-43 ◽  
Author(s):  
MARK D. CUNNINGHAM ◽  
THOMAS J. REIDY
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Criminal History ◽  
Violence Risk ◽  
Illusory Correlation ◽  
Future Dangerousness ◽  
Patterns Of Behavior ◽  
Effects Of Aging

The life and death context of a capital risk assessment requires a comprehensive forensic evaluation. Mental health professionals routinely testify regarding future dangerousness in capital proceedings but too often limit assessment to DSM-IV diagnoses and criminal history without integrating empirical and actuarial data from other sources. Given the grave magnitude of a capital risk assessment both for the defendant and society, methodological and conceptual errors of this type must be avoided. This article will describe violence risk-assessment errors made by mental health professionals testifying at capital sentencing. Observed errors include inadequate reliance on base rates, failure to consider context, susceptibility to illusory correlation, failure to define severity of violence, overreliance on clinical interview, misapplication of psychological testing, exaggerated implications of antisocial personality disorder, ignoring the effects of aging, misuse of patterns of behavior, neglect of preventive measures, insufficient data, and failure to express the risk estimate in probabilistic terms.

scholarly journals Violence Risk Assessment Practices in Denmark: A Multidisciplinary National Survey

2015 ◽  
Vol 21 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Louise Hjort Nielsen ◽  
Sarah van Mastrigt ◽  
Randy K. Otto ◽  
Katharina Seewald ◽  
Corine de Ruiter ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Risk Management ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Assessment Practices ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Risk Monitoring ◽  
Professional Disciplines

Abstract With a quadrupling of forensic psychiatric patients in Denmark over the past 20 years, focus on violence risk assessment practices across the country has increased. However, information is lacking regarding Danish risk assessment practice across professional disciplines and clinical settings; little is known about how violence risk assessments are conducted, which instruments are used for what purposes, and how mental health professionals rate their utility and costs. As part of a global survey exploring the application of violence risk assessment across 44 countries, the current study investigated Danish practice across several professional disciplines and settings in which forensic and high-risk mental health patients are assessed and treated. In total, 125 mental health professionals across the country completed the survey. The five instruments that respondents reported most commonly using for risk assessment, risk management planning and risk monitoring were Broset, HCR-20, the START, the PCL-R, and the PCL:SV. Whereas the HCR-20 was rated highest in usefulness for risk assessment, the START was rated most useful for risk management and risk monitoring. No significant differences in utility were observed across professional groups. Unstructured clinical judgments were reported to be faster but more expensive to conduct than using a risk assessment instrument. Implications for clinical practice are discussed.

Risk assessment in a climate of litigation

1997 ◽  
Vol 170 (S32) ◽  
pp. 37-39 ◽  
Author(s):  
Glynn Harrison
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Public Attitudes ◽  
Difficult Patients ◽  
Civil Action ◽  
Vulnerable Patients ◽  
Potential Benefits

There has been a sea change in public attitudes toward the use of litigation in medicine over recent years. Mental health professionals are beginning to add an additional factor to their risk calculations when managing difficult patients: the assessment of risk (of a civil action) to themselves in the event of an untoward incident. This development must be recognised and anticipated if we are to assess fully the potential benefits, and the costs, of closer surveillance of vulnerable patients in the community.

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