Examination of risk assessment tools developed to evaluate risks in mental health areas: A systematic review

Nursing Forum ◽  
2021 ◽  
Author(s):  
Fatma Ayhan ◽  
Besti Üstün
2021 ◽  
pp. 103985622098403
Author(s):  
Marianne Wyder ◽  
Manaan Kar Ray ◽  
Samara Russell ◽  
Kieran Kinsella ◽  
David Crompton ◽  
...  

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.


2020 ◽  
Vol 13 (3) ◽  
pp. 247-263
Author(s):  
Hannah J. White ◽  
Jensyn Bradley ◽  
Nicholas Hadgis ◽  
Emily Wittke ◽  
Brett Piland ◽  
...  

CNS Spectrums ◽  
2019 ◽  
Vol 25 (5) ◽  
pp. 593-603
Author(s):  
Sarah L. Desmarais ◽  
Evan M. Lowder

Eligibility criteria for participation in mental health jail diversion programs often specify that, to be diverted, a candidate must not pose a level of threat to public safety that cannot be managed in the community. Risk assessment tools were developed to increase consistency and accuracy in estimates of threat to public safety. Consequently, risk assessment tools are being used in many jurisdictions to inform decisions regarding an individual’s appropriateness and eligibility for mental health jail diversion and the strategies that may be successful in mitigating risk in this context. However, their use is not without controversy. Questions have been raised regarding the validity and equity of their estimates, as well as the impact of their use on criminal justice outcomes. The purpose of this review is to provide an overview of the science and practice of risk assessment to inform decisions and case planning in the context of mental health jail diversion programs. Our specific aims include: (1) to describe the process and components of risk assessment, including differentiating between different approaches to risk assessment, and (2) to consider the use of risk assessment tools in mental health jail diversion programs. We anchor this review in relevant theory and extant research, noting current controversies or debates and areas for future research. Overall, there is strong theoretical justification and empirical evidence from other criminal justice contexts; however, the body of research on the use of risk assessment tools in mental health jail diversion programs, although promising, is relatively nascent.


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