Search results for ‘Subject term:"mental health problems"’ Sort:
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Child safety decisions and parental mental health problems: a new analysis of mediating factors
- Authors:
- ROSCOE Joseph N., LERY Bridgette, THOMPSON Doug
- Journal article citation:
- Child Abuse and Neglect, 120, 2021, p.105202.
- Publisher:
- Elsevier
Background: Our previous study showed that parents with mental health problems or substance abuse are at increased risk of having children removed from the home, primarily due to caregiving deficits, neglect, and prenatal exposure to substances, not physical abuse. Objective: Using a larger sample and more rigorous analysis, the present study improves and expand upon the previous study, yielding more robust explanations for why these children are at increased risk of removal. Participants and setting: The study uses a sample of 4070 Structured Decision Making® assessments conducted by San Francisco's Child Welfare provider involving parents reported for the first time from 2007 to 2015. Methods: Using structural equation modeling, mediation models were constructed to test the indirect effects of thirteen child safety threats on safety decision. Results: Four threats explained 95% of the effect of mental health problems on safety decision, two of which retained significance in the final model: Failure to Meet Immediate Needs (OR = 1.26, p ≤ 0.01) and Previous Maltreatment (OR = 1.24, p ≤ 0.05). Seven safety threats explained 91% of the effect of co-occurring mental health problems and substance abuse, two of which retained significance in the final model: Failure to Meet Immediate Needs (OR = 1.78, p ≤ 0.001) and Physical Harm (Drug-Exposed Infant; OR = 1.57, p ≤ 0.001). Conclusions: As previously shown, parental mental health problems and substance abuse are not ipso facto safety threats. Rather, unmet child needs account for much of the increased risk of child removal in this population, underscoring the importance of timely resource referrals. (Edited publisher abstract)
The evidence on how nurses approach risk assessment
- Author:
- BRUNTON Keith
- Journal article citation:
- Nursing Times, 12.07.05, 2005, pp.38-40.
- Publisher:
- Nursing Times
Over the past decade there have been a number of public enquiries that have forced nurses to improve their decision-making skills in risk assessment. This article reviews the literature on how psychiatric nurses assess risk. It examines the different risk-management strategies used, discusses the rationale behind them and highlights recent research looking at how nurses assess the risk of violence in crisis situations.
Something wrong
- Author:
- COHEN Phil
- Journal article citation:
- Community Care, 15.1.98, 1998, p.10.
- Publisher:
- Reed Business Information
Asks what is going wrong with suicide risk assessment of mentally ill people. Looks at a report of a major national inquiry which reveals a gap in the quality of training.
Applicability of the DUNDRUM-1 in a forensic Belgium setting
- Authors:
- HABETS Petra, DARME Inge Jean, KENNEDY Harry G.
- Journal article citation:
- Journal of Forensic Practice, 21(1), 2019, pp.85-94.
- Publisher:
- Emerald
Purpose: Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Research regarding the assessment of security level is minimal and few instruments are available. The DUNDRUM toolkit is a structured clinical judgement instrument that can be used to provide support when determining security level. The purpose of this paper is to investigate the applicability and validity of the DUNDRUM-1 in Flanders. Design/methodology/approach: The DUNDRUM-1 was scored for 50 male patients admitted at the forensic units in the public psychiatric hospital Rekem. Some files were rated by three researchers who were blind to participants’ security status, resulting in 33 double measurements. Findings: Almost all files (96 per cent) contained enough information to score the DUNDRUM-1. Average DUNDRUM-1 final judgement scores were concordant with a medium security profile. No difference was found between the current security levels and the DUNDRUM-1 final judgement scores. Inter-rater reliability was excellent for the DUNDRUM-1 final judgement scores. On item level, all items had excellent to good inter-rater reliability with the exception of one item institutional behaviour which had an average inter-rater reliability. Practical implications: The DUNDRUM-1 can be a useful tool in Flemish forensic settings. It has good psychometric properties. More research is needed to investigate the relationship between DUNDRUM-1 scores and security level decisions by the courts. Originality/value: This is the first study that investigated the applicability of the DUNDRUM-1 in a Belgian setting, also a relative large number of repeated measurements were available to investigate the inter-rater reliability of the DUNDRUM-1.
Recovery versus risk? from managing risk to the co-production of safety and opportunity
- Authors:
- PERKINS Rachel, REPPER Julie
- Journal article citation:
- Mental Health and Social Inclusion, 20(2), 2016, pp.101-109.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to propose a recovery-focused approach to risk and safety and what this might look like in practice. Design/methodology/approach: Review of recovery approaches and the ways in which traditional approaches to risk might hinder people in their recovery journey. Consideration of the principles of a recovery-focused approach to safety. Findings: A recovery-focused approach to risk based on co-produced safety plans that enable people to do the things they value as safely as possible and shared responsibility for safety. Four key principles of a recovery-focused approach to promoting safety, autonomy and opportunity are proposed. Originality/value: A recovery-focused approach to risk and safety is central to the development of recovery-focused practice within services. This paper outlines such an approach. (Publisher abstract)
‘Rabone’ and four unresolved problems in mental health law
- Authors:
- SZMUKLER George, RICHARDSON Genevra, OWEN Gareth
- Journal article citation:
- Psychiatrist (The), 37(9), 2013, pp.297-301.
- Publisher:
- Royal College of Psychiatrists
In a landmark decision, the Supreme Court of the UK ruled that the state has a special operational duty to protect the right to life in informal psychiatric in-patients (‘Rabone case’), in sharp distinction to general medical or surgical patients. In the case, 24 year-old Melanie Rabone died by hanging on 20 April 2005. The previous day she had been allowed home leave from a psychiatric unit where she had been admitted on 11 April. She had previous history of self-harm and attempted suicide. This article examines the implications of this decision for mental health law and for understandings of the nature of mental healthcare. The authors argue that the significance of this case is general, not just local, and that it exposes four important unresolved problems in mental health law: the place of decision-making capacity; the meaning of ‘informal’ admission; parity between mental and physical health; and the accuracy of risk assessment. (Edited publisher abstract)
Clinical assessment of risk decision support (CARDS): the development and evaluation of a feasible violence risk assessment for routine psychiatric practice
- Authors:
- WATTS David, et al
- Journal article citation:
- Journal of Mental Health, 13(6), December 2004, pp.569-581.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Adult psychiatric services are increasingly required to assess and manage the risk of violence, but the evidence base to guide clinical practice is limited. The aim was to develop an evidence-based method of assessing risk of violence and to demonstrate its feasibility in routine practice. Consensus workshops were held to design a form based decision support system, which was refined using a Delphi consultation. The system was introduced into practice in 7 mental health services in England. Its feasibility was measured through assessment of case notes, questionnaires and focus groups of clinical staff. CARDS is a two-stage assessment, with a screen and full assessment stage. A high degree of consensus was achieved for the structure and content. CARDS met each of the six feasibility criteria: brevity, simplicity, relevance, acceptability, availability and value, though acceptability was only achieved when the assessment of violence risk was supplemented with an assessment of suicide risk. CARDS provides a feasible, evidence-based decision support procedure for assessing risk of violence in patients using adult mental health services. It can help clinicians meet policy requirements to assess risk, though its effect on actual violence is unknown.
Therapist or public protector? - the dilemma of the professional in Mental Health
- Author:
- HEDGECOCK Wendy
- Journal article citation:
- Kent Journal of Practice Research, 1(3), September 1997, pp.51-56.
This article examines the dilemma in which the author, an occupational therapist, has increasingly found herself over recent months. The situation is question is that where the mental health professional has to decide whether their role as protector of public interest should take precedence over their role as therapist. Recent government legislation and guidelines such as the Care Programme Approach, the Supervision Register and Supervised Discharge have emphasised the need for good risk assessment and management. These recommendations reflect issues highlight in the published reports of inquiries into serious offences committed by people diagnosed as having severe mental health problems. Discusses how this emphasis on risk management has implications regarding the autonomy of both the client and the professional. It also invites the question as to whom the professional's first allegiance must be.