The Oxford Handbook of Behavioral Emergencies and Crises

2014 ◽  
Keyword(s):  
Risk Management ◽  
High Risk ◽  
Interpersonal Violence ◽  
Medical Center ◽  
Violent Behavior ◽  
The Elderly ◽  
Negative Consequences ◽  
Behavioral Emergencies ◽  
Serious Injury ◽  
Ethical Risk Management

The Oxford Handbook of Behavioral Emergencies and Crisesincludes the most up-to-date and valuable research on the evaluation and management of arguably the most challenging patients faced by mental health practitioners—that is, individuals who are at high risk of suicide or other-directed violence or of becoming the victims of interpersonal violence. The outcome with such cases can be serious injury or death, and there can be negative consequences for the patient, and also for the patient’s family and friends, for the clinician, and for the clinic or medical center. This book presents a framework for learning the skills to assess and work competently with these patients. The book has sections dealing with such critical incidents in children, adolescents, adults, and the elderly. There are sections to aid clinicians with conditions that need to be distinguished from behavioral emergencies; on treating patients or clients who have ongoing chronic risk of harming themselves or others; and on legal and ethical risk management as well as psychological risk management for the clinician in the event of a negative outcome. The book examines interrelated aspects of the major behavioral emergencies; for example, the degree to which interpersonal victimization may lead an individual to later suicidal or violent behavior; or the degree to which suicidal individuals and violent individuals may share certain cognitive characteristics. It also presents a method for reducing the clinician’s stress and acquiring skill in working with high-risk people.

Legal and Ethical Risk Management with Behavioral Emergencies

2015 ◽  
Author(s):  
Dana Lockwood ◽  
Houri Parsi ◽  
Wendy Packman ◽  
Bruce Bongar
Keyword(s):  
Mental Health ◽  
Risk Management ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Standard Of Care ◽  
Treatment Providers ◽  
Behavioral Emergencies ◽  
Ethical Risk Management

Working with patients presenting with serious harm to themselves or others is an experience many mental health professionals will have during their careers. The possibility of working with this population might cause some apprehension for treatment providers because of the patient and professional risks involved. In this chapter we review the applicable legal theories of professional negligence and focus on the potential legal and professional ramifications that occur when mental health professionals do not rise to the applicable standard of care when working with suicidal or aggressive patients. Additionally, this chapter provides an outline of the legally imposed duties that treatment providers have to their patients so as to promote effective and ethical treatment of those presenting with the possibility of serious harm to themselves and others.

Abstract TMP105: High Utilization Of CAS Procedures Among The Elderly In The Post Crest Era

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Mahmoud Rayes ◽  
Pratik Bhattacharya ◽  
Rahul Damani ◽  
Seemant Chaturvedi
Keyword(s):  
High Risk ◽  
Elderly Patients ◽  
Medical Center ◽  
Significant Proportion ◽  
The Elderly ◽  
Carotid Revascularization ◽  
Choice Of Procedure ◽  
Asymptomatic Patients ◽  
Risk Criterion ◽  
Specific Symptoms

Background: An important interaction of age with outcome was revealed in Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) where elderly patients ≥70 years had worse outcomes with Carotid stenting (CAS) than with Endarterectomy (CEA). Our hypothesis was that following the CREST study, the proportion of CAS procedures in the elderly would decrease. Methods: We performed a retrospective review of carotid revascularization procedures between June 2009 and April 2012 at a large volume urban medical center. Demographics, indications, surgical high-risk criteria and outcomes of in-hospital stroke/death/MI were collected. Data analysis was performed in subjects over 70 years. Time trends were examined in the post-CREST period. Results: A total of 701 procedures (CEA 36%, CAS 64%) were performed during the study period, of which 360 (51.4%) were in patients ≥70 years (CEA 33%, CAS 67%). A significant proportion (22.1%) was in those ≥80 years. The choice of procedure did not change following CREST. The majority of CAS procedures in elderly (90.8%) were performed by cardiologists. Asymptomatic patients (47.3%) and patients with non-specific symptoms (18.7%) comprised a large proportion of this subgroup. A third of elderly patients with asymptomatic and nonspecific symptoms did not have any surgical high-risk criterion. The proportion of elderly patients receiving CAS for non-specific symptoms increased progressively over time post CREST (27.9% in the most recent months). A similar rise in non-specific indications was noted in the subgroup of patient ≥80 years receiving CAS. About half of this subgroup did not have any surgical high-risk criterion. Conclusion: Two years after CREST results, CAS continues to be performed among the elderly, often for non-specific symptoms or in asymptomatic patients. The lack of a decrease in CAS procedures in the elderly raises questions about whether evidence-based carotid revascularization occurs in the real world.

Suicide in Nógrád County, Hungary, 1970-1994

Crisis ◽  
1999 ◽  
Vol 20 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Tamás Zonda
Keyword(s):  
High Risk ◽  
Psychiatric Disorders ◽  
Suicide Rate ◽  
Risk Groups ◽  
The Elderly ◽  
Female Ratio ◽  
Suicide Notes ◽  
Suicidal Intention ◽  
Male Female Ratio

The author examined completed suicides occurring over a period of 25 years in a county of Hungary with a traditionally low (relatively speaking) suicide rate of 25.8. The rates are clearly higher in villages than in the towns. The male/female ratio was close to 4:1, among elderly though only 1.5:1. The high risk groups are the elderly, divorced, and widowed. Violent methods are chosen in 66.4% of the cases. The rates are particularly high in the period April-July. Prior communication of suicidal intention was revealed in 16.3% of all cases. Previous attempts had been undertaken by 17%, which in turn means that 83% of suicides were first attempts. In our material 10% the victims left suicide notes. Psychiatric disorders were present in 60.1% of the cases, and severe, multiple somatic illnesses (including malignomas) were present in 8.8%. The majority of the data resemble those found in the literature.

Long-term relations between violent media use and violent behavior by delinquents, criminals, and high-risk adolescents

2011 ◽  
Author(s):  
Rowell Huesmann ◽  
Paul Boxer ◽  
Tom Johnson ◽  
Wendy Garrard ◽  
Maureen O'Brien
Keyword(s):  
High Risk ◽  
Media Use ◽  
Violent Behavior ◽  
Violent Media

FORMALIZED DESCRIPTION OF THE PROCEDURE OF INFORMATION SYSTEM RISK MANAGEMENT

2018 ◽  
pp. 61-70
Author(s):  
Svetlana Sergeevna Kozunova ◽  
Alla Grigorievna Kravets
Keyword(s):  
Information System ◽  
Risk Management ◽  
Negative Consequences ◽  
Management Procedure ◽  
System Risk ◽  
Weak Points ◽  
Formalized Description ◽  
Relationship Of ◽  
The Relationship ◽  
Further Development

The article highlights the aspects of risk management in the information system. According to the analysis of the work of Russian and foreign scientists and world practices in the field of risk management, it is stated that there is a need to improve the effectiveness of risk management of information system and to develop a method for managing the risks of the information system. As a solution to the problem of effective risk management of the information system, there has been proposed a formalized procedure for managing the risks of the information system. The scientific novelty of this solution is the use of decision space and optimization space to reduce risks. This procedure allows to assess the damage, risk and effectiveness of risk management of the information system. The risks of the information system are determined and analyzed; a pyramidal risk diagram is developed. This diagram allows you to describe the relationship of risks with the components of the information system. The negative consequences to which these risks can lead are given. The analysis of methods and approaches to risk management has been carried out. Based on the results of the analysis, the methods GRAMM, CORAS, GOST R ISO / IEC scored to the maximum. The weak points of these methods and the difficulty of applying these methods in practice are described. The developed formalized risk management procedure to control the risks of information system can be used as management system’s element of the information security quality that complies with the recommendations of GOST R ISO / IEC 27003-2012. The prospect of further development of the research results is the development of management systems of risk of information system.

Behavioral Emergencies and Crises

2010 ◽  
pp. 739-762
Author(s):  
Phillip M. Kleespies ◽  
Justin M. Hill
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
High Risk ◽  
Work Environment ◽  
Emotional Impact ◽  
High Risk Patients ◽  
Risk Patients ◽  
Life Threatening ◽  
Behavioral Emergencies ◽  
And Training

This chapter illustrates the mental health clinician’s relationship with behavioral emergencies. The chapter begins by distinguishing the terms behavioral emergency and behavioral crisis, and underlying themes among all behavioral emergencies are identified. Given that most clinicians will face a behavioral emergency in their careers, the importance of enhancing the process of educating and training practitioners for such situations far beyond the minimal training that currently exists is highlighted. The chapter continues by exploring various aspects of evaluating and managing high-risk patients (i.e., those who exhibit violent tendencies toward themselves or others, and those at risk for victimization). It includes a discussion of the benefits and limitations to estimating life-threatening risk factors and specific protective factors. The chapter concludes by discussing the emotional impact that working with high-risk patients has on clinicians, and an emphasis is placed on the importance of creating a supportive work environment.

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