Risk assessment: Not a tick box exercise 

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By Suzanne Traynor @Traynors
Associate Professor Mental Health (Practice) at Middlesex University & My Care Academy.

Supporting mental health staff to develop their skills and confidence in the assessment of risk is a core requirement for all Trusts. My Care Academy (MyCA) in partnership with Camden and Islington NHS Foundation Trust have developed a bespoke training day for all staff: Keeping the Patient Safe

My Care Academy is a knowledge building community and the Keeping the Patient Safe training day was co-produced with service users, Trust, academic and MyCA staff. The learning outcomes and content were agreed following a series of curriculum development meetings as well as informal feedback from staff and service users in the Trust. Multidisciplinary staff have the opportunity to learn together, reflect on their current practice as well as update themselves regarding new evidence base and knowledge shared through lessons learnt. Some of the key themes we explore are risk assessment, engaging relationships, formulation and care planning.

 

What does a good risk assessment look like?

  • The key to good risk assessment is one that is based on a collaborative relationship with the service user and when possible including their family and important social networks
  • Risk management plans should be developed with the service user in an atmosphere of openness and collaboration
  • Risk assessment works best when the focus is on the strengths of the service users
  • Managing risk is everybody’s business and all staff will have access to training to support their practice in risk assessment.


On a regular basis, staff ask about tools that could be used to support their assessment as they feel that this could ensure a robustness to their assessment that may be lacking without. However, a recent report of a national study on the use of risk assessment tools across mental health services summarised their findings:

  • Risk assessment tools should not be used as a sole means of predicting future suicidal behaviour
  • Risk assessment is not a checklist and treatment options should not be determined by a score
  • The emphasis should be on building relationships with the patient and gathering good quality information
  • Staff need consistent training with particular reference to assessment, formulation and management of risk
  • Family carers should be involved in the assessment process as much as possible
  • Supervision is an important part of ensuring consistency of practice
  • Risk assessment requires a whole system approach to ensure safe care for the patient


@NCISH_UK

 

Click here to watch a short film of the summary of this report.

Further reading:

The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Annual report: England, Northern Ireland, Scotland and Wales. Manchester: University of Manchester. 2017.
http://documents.manchester.ac.uk/display.aspx?DocID=37560

Worthington A, Rooney P, Hannan R. the Triangle of Care, Carers included: A guide to best practice in mental health care in England. London: Carers Trust 2013
https://professionals.carers.org/sites/default/files/thetriangleofcare_guidetobestpracticeinmentalhealthcare_england.pdf

 

 

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