Risk Assessment in Mental Health
45 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is defined as the possibility of loss in a clinical setting?

  • Responsibility
  • Independence
  • Assessment
  • Risk (correct)
  • Which type of risk factors are static and do not change over time?

  • Situational risk factors
  • Environmental risk factors
  • Dynamic risk factors
  • Static risk factors (correct)
  • What is a limitation of risk assessments in psychiatry?

  • They are always informative.
  • They only focus on protective factors.
  • They provide complete certainty.
  • They can be biased and have blind spots. (correct)
  • Which approach calculates risk through records and statistics?

    <p>Actuarial approaches (B)</p> Signup and view all the answers

    How is a standard NHS risk assessment primarily characterized?

    <p>Informed process to reduce uncertainty (C)</p> Signup and view all the answers

    What is the best predictor of future violence in individuals with mental illness?

    <p>Past history of violence (B)</p> Signup and view all the answers

    Which factor has been shown to increase the risk of violence in individuals with mental illness?

    <p>Combination of substance misuse and non-concordance with medications (A)</p> Signup and view all the answers

    Which type of risk involves being a victim rather than a perpetrator of crime in individuals with mental illness?

    <p>Risk from others (C)</p> Signup and view all the answers

    What socio-demographic factor is considered a major determinant of violence?

    <p>Socio-economic status (C)</p> Signup and view all the answers

    In terms of risk to health, which situation exemplifies a critical concern for individuals experiencing severe psychotic symptoms?

    <p>Not eating due to paranoia (B)</p> Signup and view all the answers

    Which of the following statements reflects a common misconception about individuals with mental illness?

    <p>They pose a disproportionate risk of violence. (C)</p> Signup and view all the answers

    Which scenario best describes environmental risk factors related to violence?

    <p>Access to weapons (C)</p> Signup and view all the answers

    What role does substance misuse play in the context of violence and mental illness?

    <p>It increases the risk of violence significantly. (D)</p> Signup and view all the answers

    Which mental disorder has the highest relative risk (RR) for suicide?

    <p>Psychosis (B)</p> Signup and view all the answers

    Which of the following is considered a static risk factor for suicide?

    <p>Age at first diagnosis (C)</p> Signup and view all the answers

    What is a common protective factor against suicide?

    <p>Strong religious faith (B)</p> Signup and view all the answers

    Which group is reported to be three times more likely to die by suicide?

    <p>Males (B)</p> Signup and view all the answers

    Which of the following factors is NOT a dynamic risk factor for suicide?

    <p>Age (C)</p> Signup and view all the answers

    What recent experience can significantly increase the risk of suicide?

    <p>Previous self-harm or suicide attempt (D)</p> Signup and view all the answers

    In a case scenario, a 49-year-old male identifies his children as a protective factor. What else might be a protective factor?

    <p>Sense of responsibility (A)</p> Signup and view all the answers

    What is one of the key focuses after a serious untoward incident involving suicide risk?

    <p>Learning and preventing future harm (D)</p> Signup and view all the answers

    What is an example of a risk behavior that can occur outside the home?

    <p>Accidental harm due to wandering (C)</p> Signup and view all the answers

    What should be monitored to assess physical health risks adequately?

    <p>Access to a General Practitioner (GP) (B)</p> Signup and view all the answers

    Which of the following indicates a need for safeguarding children?

    <p>Presence of a young carer (C)</p> Signup and view all the answers

    Which risk behavior is specifically associated with physical health?

    <p>Use of IV drugs (C)</p> Signup and view all the answers

    What does MARAC stand for in the context of domestic safety?

    <p>Multi-agency Risk Assessment Conference (C)</p> Signup and view all the answers

    Which of the following is a potential outcome of non-compliance with treatment plans?

    <p>Relapsing mental state (C)</p> Signup and view all the answers

    What is a sign of financial abuse that can indicate control over an individual?

    <p>Locks on doors to prevent leaving (D)</p> Signup and view all the answers

    Which behavior is an indicator of risk due to substance misuse?

    <p>Sharing needles (D)</p> Signup and view all the answers

    What is a primary consideration when assessing risk posed by a partner or family member?

    <p>Financial abuse (B)</p> Signup and view all the answers

    What factor increases the likelihood of individuals with mental illness becoming victims?

    <p>Lifetime prevalence of victimization (B)</p> Signup and view all the answers

    Which risk does NOT directly relate to the assessment of harm to others?

    <p>Self-neglect (D)</p> Signup and view all the answers

    Which of the following is a component of the NHS Psychiatric Risk Assessment Tool related to risk to self?

    <p>Harmful eating patterns (C)</p> Signup and view all the answers

    Which type of violence is NOT typically included in forms of risk from others?

    <p>Coping strategies (D)</p> Signup and view all the answers

    What is a sign that could indicate a risk of radicalisation in adult safeguarding?

    <p>Weapon possession (B)</p> Signup and view all the answers

    What emotional aspect can contribute to the risk from others?

    <p>Fear of physical harm (B)</p> Signup and view all the answers

    Which of the following is associated with high-risk domestic or sexual abuse assessments?

    <p>Bullying or comments (B)</p> Signup and view all the answers

    What is a primary characteristic of risk assessments?

    <p>They must be individualized to the client's needs. (C)</p> Signup and view all the answers

    Which of the following statements is true regarding the function of risk assessments?

    <p>They help inform clinical care to mitigate potential risks. (A)</p> Signup and view all the answers

    Why must risk assessments be up-to-date?

    <p>To reflect the most current understanding of a patient's risk. (D)</p> Signup and view all the answers

    What aspect of risk assessments is highlighted as necessary for their effectiveness?

    <p>They need to be dynamic and responsive. (D)</p> Signup and view all the answers

    Which of the following is NOT essential for a risk assessment?

    <p>Being based solely on administrative data. (D)</p> Signup and view all the answers

    How should interactions with patients influence risk assessments?

    <p>They provide essential information for thorough assessments. (B)</p> Signup and view all the answers

    Which phrase best captures the limitations of risk assessments?

    <p>They cannot entirely eliminate risks. (B)</p> Signup and view all the answers

    What does it mean for a risk assessment to be responsive?

    <p>It adjusts according to changes in the patient's condition. (A)</p> Signup and view all the answers

    Flashcards

    Risk in Mental Health

    The probability of harm, loss, or negative outcomes in a clinical setting, encompassing immediate, delayed, long-term, and chronic possibilities.

    Dynamic vs. Actuarial Risk

    Dynamic risk is changeable and responsive to interventions, while actuarial risk uses statistics and records to predict risk. Actuarial risk is often more statistical while dynamic risk is more personal.

    Risk Assessment Tool

    A structured method, often used in the NHS, for evaluating various types of risk in a mental health setting.

    Risk Factors (Static vs. Dynamic)

    Static risk factors are unchanging aspects that increase risk (e.g., past history). Dynamic factors change over time because of interventions or behaviors (e.g., current mood or social settings).

    Signup and view all the flashcards

    Limitations of Risk Assessments

    Risk assessments may not account for complex human behavior or be perfectly accurate because of the limits of predicting behaviors. They are approximations of risk and can be inaccurate.

    Signup and view all the flashcards

    Suicide Risk Factors

    Characteristics or situations that increase the probability of a suicidal event occurring.

    Signup and view all the flashcards

    Static Risk Factor

    Risk factor that does not change over time, e.g., childhood experiences, age at initial diagnoses.

    Signup and view all the flashcards

    Dynamic Risk Factors

    Risk factor that can change over time, e.g., mental state, support systems, environment.

    Signup and view all the flashcards

    Previous Suicide Attempt

    A significant risk factor indicating a higher likelihood of future attempts.

    Signup and view all the flashcards

    Protective Factors

    Conditions that decrease the risk of an adverse event, including suicide, e.g., social support, a strong sense of responsibility.

    Signup and view all the flashcards

    Mental Disorders and Suicide

    Mental disorders significantly increase the risk of suicide.

    Signup and view all the flashcards

    Male Gender Suicide Risk

    Males have a higher suicide risk compared to females, although women experience suicidal ideation more frequently.

    Signup and view all the flashcards

    Assessing Suicide Risk

    A crucial process to identify and manage individuals at risk of suicidal behaviors.

    Signup and view all the flashcards

    Child Safeguarding

    Protecting children from harm, abuse, and neglect.

    Signup and view all the flashcards

    Adult Safeguarding

    Protecting vulnerable adults from harm, abuse, and neglect.

    Signup and view all the flashcards

    Domestic Violence

    Abuse by a partner or family member.

    Signup and view all the flashcards

    Psychiatric Risk Assessment

    Evaluating risk of harm to self or others.

    Signup and view all the flashcards

    Risk to Self

    Potential for harm directed at oneself.

    Signup and view all the flashcards

    Risk to Others

    Potential for violence or harm toward others.

    Signup and view all the flashcards

    Risk Assessment

    Evaluating the likelihood of a harmful event.

    Signup and view all the flashcards

    Self-harm

    Intentional harm to oneself (e.g., cutting, burning).

    Signup and view all the flashcards

    Risk factors for violence

    In combination with mental illness, other factors like substance misuse, and lack of adherence to treatment increase the risk of violence. Poor environment also contributes.

    Signup and view all the flashcards

    History of violence

    A significant predictor of future violent behavior, independent of current mental state or illness.

    Signup and view all the flashcards

    Mental state - Violence risk

    Symptoms like threats, control issues, extreme emotions, thoughts connecting violence and suicide, psychopathy, and lack of insight contribute to the violence risk.

    Signup and view all the flashcards

    Risk to health

    Harm that can come from serious mental disorders, including failure to adhere to medication or basic self-care.

    Signup and view all the flashcards

    Schizophrenia and violence

    Studies show a possible link, but the risk is not necessarily higher than in the general population. Often, substance abuse, combined with schizophrenia, is the cause of violent tendencies.

    Signup and view all the flashcards

    Continuity of care issues

    Frequent changes in treatment providers, locations, and insufficient ongoing care that can make it difficult to manage mental health conditions.

    Signup and view all the flashcards

    Coercion

    Forcing someone to do something against their will, using threats or intimidation.

    Signup and view all the flashcards

    Control in Mental Health

    Restricting someone's freedom or choices, often related to finances, medication, or social interactions.

    Signup and view all the flashcards

    Risk of Accidents

    The likelihood of someone experiencing an accident, outside of their home, due to their health condition or behavior.

    Signup and view all the flashcards

    Risk to Children or Vulnerable Adults

    Situations where a person's actions or condition pose a threat to the safety of children or adults who are vulnerable.

    Signup and view all the flashcards

    MAPPA

    A multi-agency system to manage high-risk individuals, usually related to sexual or violent offenses, involving police, social services, and probation.

    Signup and view all the flashcards

    MARAC

    A meeting with different agencies (police, social services, health) to discuss a specific case of domestic abuse and create a safety plan.

    Signup and view all the flashcards

    Physical Health Risks

    Potential health issues for individuals, including access to healthcare, lack of care, and the use of medications.

    Signup and view all the flashcards

    Substance Misuse Risks

    Potential harms related to drug or alcohol use, such as IV drug use, sharing needles, overdosing, and impacting caregiving responsibilities.

    Signup and view all the flashcards

    Up-to-date Risk Assessments

    Risk assessments need to be current and reflect the latest information about the individual and their situation.

    Signup and view all the flashcards

    Accurate Risk Assessments

    Assessments should be based on reliable and validated information, not assumptions or biases.

    Signup and view all the flashcards

    Individualized Risk Assessments

    Each person is unique, so their risk assessment should be tailored to their specific circumstances, not a generic template.

    Signup and view all the flashcards

    Responsive Risk Assessments

    Risk assessments shouldn't be static. They need to adapt to changes in the individual's situation and their responses to treatment.

    Signup and view all the flashcards

    Risk Mitigation

    Risk assessments don't prevent problems, but they help us take action to reduce the likelihood or impact of negative events.

    Signup and view all the flashcards

    Clinical Interaction's Role

    Every interaction with a patient contributes to understanding their risk profile, providing valuable information for the assessment.

    Signup and view all the flashcards

    Risk Assessment in Mental Health

    Evaluating the likelihood of harmful events for individuals with mental health conditions.

    Signup and view all the flashcards

    Why are risk assessments important?

    They help healthcare professionals make informed decisions to protect patients and provide appropriate care.

    Signup and view all the flashcards

    Study Notes

    Risk Assessment and Mental Health

    • The presentation covers risk assessment in clinical settings, including suicide and harm to others.
    • Aims to highlight various risk presentations, introduce risk assessment/management approaches in psychiatry, and empower professionals regarding risk discussions.
    • Objectives include defining risk types, listing risk factors (static vs. dynamic), applying a standard NHS risk assessment tool, and discussing risk assessment limitations.
    • The session's outline includes a lecture on risk, group discussions on cases, and a summary/Q&A.
    • Risk is defined as the possibility of loss (immediate, delayed, long-term, chronic), and introduces the dynamic vs actuarial approaches.

    General Principles

    • Risk assessment affects all aspects of psychiatric practice.
    • A holistic, individual, and responsive approach is crucial.
    • Multidisciplinary collaboration is essential.
    • Risk versus protective factors are considered.

    Actuarial Approaches

    • Actuarial approaches utilize records and statistics to calculate risk.
    • This approach is structured, empirically-based, and objective.
    • Questions of rigidity and reliability are raised.

    Clinical Assessment

    • Clinical assessment is conducted by clinicians and is historically informed.
    • The aim is to be responsive and dynamic.
    • Potential biases and blind spots in clinical assessments are recognised.

    Risk Assessment

    • Risk assessment considers the size and acceptability of risk, along with dangerousness and likelihood.
    • Risk assessment is a dynamic process.
    • A comparison between clinical and actuarial assessments (with their respective advantages and disadvantages) is presented.
    • It is impossible to eliminate risk at an individual level.

    Why Formulate Risk

    • A working model for risk assessment is presented, including patient liaison and bringing information together.
    • Intervention and communication are crucial aspects of risk assessment.
    • A reference is included connecting risk formulation with the HCR-20 version 3.

    Assessment Linked with Action

    • The process of risk assessment involves establishing context, identifying, analyzing, evaluating, treating, and monitoring risks.
    • This approach of risk assessment has an emphasis on ongoing communication and consultations.

    Risks in Mental Health

    • Issues are discussed using examples from the news and case studies, including the violence by individuals with mental illness.

    Risk Domains in the Mental Health Act

    • The domains of risk to self, risk to others, and risk to health are outlined.

    Self Harm I

    • The Royal College of Psychiatrists indicate that 10% of the UK population experiences self-harm.
    • Common contributing circumstances include difficult personal circumstances, past trauma, social/economic deprivation, and substance misuse.

    Self Harm II

    • Self-harm is positioned as a risk in itself, a communication of distress, and representing ambivalence towards life.
    • People who self-harm have a significantly increased risk of suicide.

    Suicide I

    • England and Wales suicide rates are increasing (11.4 deaths/100,000 in 2023, which is a 7.6% increase from 2022).
    • Males account for around 75% of recorded suicide deaths.
    • Suicide rates showed a downward trend since 1981, but recent years have shown an upward trend, with 2023 producing the most deaths since 1990.

    Suicide II

    • Highest age-specific suicide rates in 2023 for men aged 45-49 (25.5/100,000) and women aged 50-54 (9.2/100,000).
    • Hanging and poisoning are the most common methods of suicide.

    Suicide III

    • Most suicides are linked to mental disorders, with an estimated 21% population attributable fraction.
    • Mental disorders significantly increase the risk of suicide (e.g., 8 times higher for people with mental disorders compared to the general population).
    • Specific mental disorders associated with higher suicide risk include psychosis, mood disorders, substance misuse, and personality disorders.

    Suicide IV

    • A pie chart illustrated the primary diagnoses for UK suicide cases in 2023.
    • Affective disorders (depression or bipolar disorder) are the most frequent primary diagnoses, followed by schizophrenia.

    Defining Risk Factors

    • Static risk factors are unchanging aspects that increase risk, such as childhood experiences, age at first diagnosis, and demographic characteristics.
    • Dynamic risk factors are aspects that change over time, including mental state, support systems, and the wider environment.

    Risk Factors for Suicide

    • Previous suicide attempts or self-harm increase suicide risk.
    • Male gender is a significant risk factor (3x higher likelihood).
    • Concurrent mental disorders and previous psychiatric treatment increase risk.
    • Unemployment, homelessness, social isolation, loneliness, alcohol/drug abuse, and physical illness are additional suicide risk factors.

    Protective Factors

    • Social support (not living alone), having children at home, a sense of responsibility, strong religious faith, problem-solving skills, and strong connections/identity are protective factors against suicide.

    Asking about Self-Harm: Examples

    • Question prompts for exploring self-harm are provided.

    Serious Untoward Incident

    • Incidents impacting patients, families, or staff are addressed with a focus on learning and preventing future harm, instead of blaming.

    Case Scenario 1

    • A 49-year-old male presenting with suicidal ideation, recent intensification of thoughts, history of previous attempts, and a protective factor of children abroad is used as a case study.
    • The case also considers how the risk might be rated.

    Case Scenario 2

    • A 29-year-old man with schizophrenia, multiple risk events, weapons history, violence to strangers, and multiple residences is presented as another clinical case.

    The Christopher Clunis Inquiry

    • Information about an inquiry into the treatment of Christopher Clunis is furnished.

    Continuity of Care

    • The Ritchie enquiry's findings highlight issues of inconsistent and inadequate care continuity with patients moving between multiple care providers.

    CQC Findings

    • The Care Quality Commission highlighted issues with inconsistent risk assessments, inadequate care planning and engagement, and poor risk mitigation associated with the discharge of one patient.

    Violence and Mental Illness

    • The presentation highlights an overemphasis on homicides by people with mental illness, which deviates from actual risk.
    • Sociodemographic and economic factors and substance misuse can be major contributors to violent acts, apart from mental illness.
    • People with mental illness are more often victims than perpetrators of crime

    Violence and Mental Illness (page 37)

    • A modest link between violence and mental illness remains a focus in recent studies, but methodological issues and possible biases in studies lead to limited conclusions.
    • Studies have shown little conclusive results on the link between schizophrenia and violent acts.

    Rates of Violence Compared

    • Studies compare violence rates in people with schizophrenia, with and without concurrent substance abuse, against matched control groups.
    • Data shows significant increase of violence rate in individuals with both schizophrenia and concurrent substance abuse disorders.

    General Principles (page 39)

    • Factors in history (past violence, engagement, substance misuse, domestic violence) are presented as risk indicators.
    • Environmental indicators (access to victims and weapons) are discussed as risk factors.
    • Mental state factors (symptoms of threat/control, violence-related thoughts, suicide, psychopathy, or restricted insight) are discussed.

    Types of risk

    • The presentation lists the types of risk as: risk to self, risk to others and risk to health.

    Risk to Health: Some Examples

    • The presentation contains examples of risk to health, such as severe psychotic symptoms, squalid/uninhabitable homes, and symptoms of depression that accompany these conditions.
    • Risk to health, including severe conditions or lack of adherence to medication, also occurs.

    Risk From Others

    • The likelihood of harm from others, including physical harm, sexual violence, emotional abuse, unlawful restrictions, or financial abuse, is addressed.
    • This presentation explores the importance of safeguarding considerations for individuals vulnerable to violence from others.

    Risk from Others (page 44)

    • Individuals with mental illnesses are frequently victims of violence more than they commit acts against others.
    • The presentation explores diverse forms of violence such as institutionalisation, ostracisation, verbal, physical, and sexual abuse, exploitation, and retraumatisation.

    Other Risk Considerations

    • A list of additional risk factors considered important to identify and discuss.

    Clinical Tools (NHS - Psychiatric Risk Assessment)

    • A list of particular features pertaining to identifying risk to self, presented as a tool for psychiatric assessment.

    Evidence of harm TO OTHERS

    • A list of harm indicators towards other individuals or groups.

    Evidence of risk of ACCIDENTS

    • The presentation provides various cases of risk to self due to accidents.

    Evidence of risk to CHILDREN or VULNERABLE ADULTS

    • Discussions of factors of risk towards children or vulnerable adults, including Multi-agency Public Protection Arrangements (MAPPA), Multi-agency Risk Assessment Conference (MARAC), disclosure of abuse, non-compliance with treatment plans, and circumstances of substance misuse.

    Physical Health risks

    • Factors are identified that pertain to physical health concerns, such as access to general practitioners (GPs), necessary investigations, and recommended treatments.

    Substance Misuse Risks

    • The presentation lists the indications and risks of substance misuse, such as IV use, needles, overdose, and sex work.
    • The presentation includes considerations for child safeguarding if the patient has children or if there are children in the household.

    Clinical Tools, HCR-20

    • The Historical/Clinical/Risk Management-20 Scale is introduced and details some of the pertinent features in clinical tools, such as past and present features, and categories of risk.

    ...AND IT'S NOT ALL ABOUT RISK ASSESSMENT

    • The presentation highlights the findings of a survey regarding risk assessments' practice in the field.
    • It explores potential over-reliance on risk assessment tools, the importance of interaction with patients, and the limited predictive value of such tools.

    Vignettes

    • A few brief case examples (vignettes) are included.

    Considerations

    • Various questions are raised about risk management practices' potential shortcomings, including over-risk-aversion, duty of care, and the role of technology in the future.

    Summary and Questions

    • An understanding of risk and its clinical significance is highlighted.
    • Crucial characteristics of effective risk assessments (being current, precise, individualized, and responsive) for successful risk identification are stated.
    • Risk assessment does not prevent but rather informs and assists in mitigating risks.

    Other Resources

    • A list of available resources for further support and information on mental health, including suicide prevention and child safeguarding, are provided.

    References

    • A list of references supporting the material presented in the presentation is detailed.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Description

    This quiz explores risk assessment practices in clinical psychiatric settings, including the evaluation of suicide and harm risks. It emphasizes the importance of understanding different risk types and factors, while also discussing the practical implications of both actuarial and dynamic approaches. Prepare to engage in group discussions and apply assessment tools in the context of mental health.

    More Like This

    Use Quizgecko on...
    Browser
    Browser