Trust and the Dilemmas of Suicide Risk Assessment in Non-government Mental Health Services

2016 ◽  
Vol 69 (2) ◽  
pp. 145-157 ◽  
Author(s):  
Gavin Lemon ◽  
Sonya Stanford ◽  
Anne-Maree Sawyer
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Services ◽  
Health Services ◽  
Suicide Risk ◽  
Suicide Risk Assessment

scholarly journals Suicide risk assessment in UK mental health services: a national mixed-methods study

2020 ◽  
Vol 7 (12) ◽  
pp. 1046-1053 ◽  
Author(s):  
Jane Graney ◽  
Isabelle M Hunt ◽  
Leah Quinlivan ◽  
Cathryn Rodway ◽  
Pauline Turnbull ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Suicide Risk ◽  
Mixed Methods Study ◽  
Suicide Risk Assessment

scholarly journals How much risk training takes place in mental health services?

2001 ◽  
Vol 25 (6) ◽  
pp. 217-219 ◽  
Author(s):  
Sue Davies ◽  
Tim Amos ◽  
Louis Appleby
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Suicide Risk ◽  
Mental Health Legislation ◽  
Hospital Policies ◽  
Harm To Others ◽  
Health Legislation

Aims and MethodThe main aim of the study was to establish the proportion of hospital trusts in England and Wales in which training in the assessment of suicide risk and risk of harm to others is available to mental health professionals. A questionnaire was sent to clinical directors covering training on these subjects and in mental health legislation, details of training and the existence of risk-related policies.ResultsSeventy-six per cent of trusts said they provided training in suicide risk assessment for junior psychiatrists; for hospital and community nurses, the figure was just over 50%. Between 50% and 60% of trusts said they provided training in the assessment of risk of harm to others. Provision of training in mental health legislation was said to occur in most trusts. In some key areas of risk management, hospital policies were uncommon.Clinical ImplicationsDespite the current importance of risk assessment in mental health services, many hospital trusts do not provide their staff with relevant training.

scholarly journals Assessment and Management of Suicide Risk in Primary Care

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 415-425 ◽  
Author(s):  
Pooja Saini ◽  
David While ◽  
Khatidja Chantler ◽  
Kirsten Windfuhr ◽  
Navneet Kapur
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Secondary Care ◽  
Suicide Risk ◽  
Clinical Sample ◽  
Primary Care Practices ◽  
Risk Assessment And Management

Background: Risk assessment and management of suicidal patients is emphasized as a key component of care in specialist mental health services, but these issues are relatively unexplored in primary care services. Aims: To examine risk assessment and management in primary and secondary care in a clinical sample of individuals who were in contact with mental health services and died by suicide. Method: Data collection from clinical proformas, case records, and semistructured face-to-face interviews with general practitioners. Results: Primary and secondary care data were available for 198 of the 336 cases (59%). The overall agreement in the rating of risk between services was poor (overall κ = .127, p = .10). Depression, care setting (after discharge), suicidal ideation at last contact, and a history of self-harm were associated with a rating of higher risk. Suicide prevention policies were available in 25% of primary care practices, and 33% of staff received training in suicide risk assessments. Conclusion: Risk is difficult to predict, but the variation in risk assessment between professional groups may reflect poor communication. Further research is required to understand this. There appears to be a relative lack of suicide risk assessment training in primary care.

Suicide risk assessment in a large public mental health service: do suicide risk classifications identify those at risk?

2021 ◽  
pp. 103985622098403
Author(s):  
Marianne Wyder ◽  
Manaan Kar Ray ◽  
Samara Russell ◽  
Kieran Kinsella ◽  
David Crompton ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Risk Assessment ◽  
High Risk ◽  
Suicide Risk ◽  
Public Mental Health ◽  
Assessment Tools ◽  
Suicide Risk Assessment ◽  
Public Mental Health Service ◽  
Risk Assessment Tools

Introduction: Risk assessment tools are routinely used to identify patients at high risk. There is increasing evidence that these tools may not be sufficiently accurate to determine the risk of suicide of people, particularly those being treated in community mental health settings. Methods: An outcome analysis for case serials of people who died by suicide between January 2014 and December 2016 and had contact with a public mental health service within 31 days prior to their death. Results: Of the 68 people who had contact, 70.5% had a formal risk assessment. Seventy-five per cent were classified as low risk of suicide. None were identified as being at high risk. While individual risk factors were identified, these did not allow to differentiate between patients classified as low or medium. Discussion: Risk categorisation contributes little to patient safety. Given the dynamic nature of suicide risk, a risk assessment should focus on modifiable risk factors and safety planning rather than risk prediction. Conclusion: The prediction value of suicide risk assessment tools is limited. The risk classifications of high, medium or low could become the basis of denying necessary treatment to many and delivering unnecessary treatment to some and should not be used for care allocation.

scholarly journals Structured Professional Judgment to Assist the Evaluation and Safety Planning of Suicide Risk: The Risk of Suicide Protocol (RoSP)

2021 ◽  
Vol 12 ◽  
Author(s):  
Nicola S. Gray ◽  
Ann John ◽  
Aimee McKinnon ◽  
Stephanie Raybould ◽  
James Knowles ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Evaluation ◽  
Suicide Risk ◽  
Professional Judgment ◽  
Health Board ◽  
Safety Planning ◽  
Nice Guidelines ◽  
Structured Professional Judgment

Background: The Risk of Suicide Protocol (RoSP) is a structured professional judgment (SPJ) scheme designed in line with NICE guidelines to improve clinicians' ability to evaluate and manage suicide risk.Aims: This study aimed to evaluate the efficacy of RoSP in two settings: (1) unexpected deaths of people in the community who were known to mental health services; and (2) an inpatient hospital specializing in the assessment and treatment of patients with personality disorder.Method: In Study 1, information from a database of unexpected deaths (N = 68) within an NHS health board was used to complete a RoSP assessment (blind to cause of death) and information from the Coroner's Court was used to assign people to suicide vs. natural causes/accidental death. In Study 2, patients (N = 62) were assessed on the RoSP upon admission to hospital and their self-injurious behaviors were recorded over the first 3 months of admission.Results: (1) Evaluations using RoSP were highly reliable in both samples (ICCs 0.93–0.98); (2) professional judgment based on the RoSP was predictive of completed suicide in the community sample (AUC = 0.83) and; (3) was predictive of both suicide attempts (AUC = 0.81) and all self-injurious behaviors (AUC = 0.80) for the inpatient sample.Conclusion: RoSP is a reliable and valid instrument for the structured clinical evaluation of suicide risk for use in inpatient psychiatric services and in community mental health services. RoSP's efficacy is comparable to well-established structured professional judgment instruments designed to predict other risk behavior (e.g., HCR-20 and the prediction of violence). The use of RoSP for the clinical evaluation of suicide risk and safety-planning provides a structure for meeting NICE guidelines for suicide prevention and is now evidence-based.

scholarly journals WARRN – a formulation-based risk assessment process: its implementation and impact across a whole country

2019 ◽  
Vol 14 (6) ◽  
pp. 399-410
Author(s):  
Robert J. Snowden ◽  
Jordan Holt ◽  
Nicola Simkiss ◽  
Aimee Smith ◽  
Daniel Webb ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Mental Health Services ◽  
Health Services ◽  
Assessment Process ◽  
Research Network ◽  
Safety Planning ◽  
Content Type ◽  
Risk Assessment Process ◽  
Health Boards

Purpose Wales Applied Risk Research Network (WARRN) is a formulation-based technique for the assessment and management of serious risk (e.g. violence to others, suicide, etc.) for users of mental health services. It has been gradually adopted as the risk evaluation and safety-planning technique for all seven health boards in Wales. The purpose of this paper is to examine the opinions of WARRN as used within these health boards. Design/methodology/approach An online survey was disseminated to NHS clinicians in secondary mental health services to evaluate their perceptions of the use and effectiveness of WARRN. Data from 486 clinicians were analysed with both quantitative and qualitative methods. Findings Results indicated that the overall impact of WARRN on secondary mental health care was very positive, with clinicians reporting increased skills in the domains of clinical risk formulation, safety-planning and communication, as well as increased confidence in their skills and abilities in these areas. Clinicians also reported that the “common-language” created by having all NHS health boards in Wales using the same risk assessment process facilitated the communication of safety-planning. Crucially, NHS staff believed that the safety of service users and of the general public had increased due to the adoption of WARRN in their health board and many believed that lives had been saved as a result. Originality/value WARRN is perceived to have improved clinical skills in risk assessment and safety-planning across Wales and saved lives.

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