Search results for ‘Subject term:"mental health problems"’ Sort:
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The prediction of violence; detection of dangerousness
- Authors:
- NORKO Michael A., BARANOSKI Madelon V.
- Journal article citation:
- Brief Treatment and Crisis Intervention, 8(1), February 2008, pp.73-91.
- Publisher:
- Oxford University Press
Contemporary evidence on the correlates of violence and the accuracy of predictions of violent outcomes is derived from a large body of research dating from approximately 1990. Substance abuse and several demographic variables have clearly been demonstrated to be significant risk factors for violence. The data on the link of various specific symptoms of psychiatric disorders to violence are inconclusive, though suggestive, because of conflicting research findings. Mental disorder does, however, represent a modest risk factor for violence. Actuarial predictions of future violence based on static nonpsychiatric characteristics achieve greater statistical accuracy than purely clinical methods, but the former are insensitive to effects of treatment and do not inform clinical intervention in an established way. Future research directions are encouraging in attempting to identify dynamic actuarial risk factors that will be both accurate and mutable. Substantive critiques of violence prediction and limitations of this body of research present a useful framework for evaluating both assumptions and conclusions about the prediction of violence in a psychiatric population.
Involving mental health service users considered to pose a risk to other people in risk assessment
- Author:
- LANGAN Joan
- Journal article citation:
- Journal of Mental Health, 17(5), October 2008, pp.471-481.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Little research or policy guidance about the involvement of mental health service users in risk assessment exists. This study aimed to explore how hospital and community-based mental health professionals assessed risk to others and the extent to which they involved service users. It also aimed to ascertain service users' knowledge of, and involvement in, risk assessment. A qualitative research methodology was used and semi-structured interviews were conducted with mental health services users and professionals. The professionals included psychiatrists, nurses, social workers and occupational therapists. Four key themes arose (i) some professionals lacked confidence or experience in discussing risk openly with service users, (ii) most were not involving service users in risk assessments, (iii) the majority of service users were unaware that professionals were undertaking risk assessments on them, and (iv) there were differing levels of agreement between professionals and service users about risk and its seriousness. There is a research and practice gap about effective means of engaging service users in risk assessment.
The predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) among institutionalised adolescents
- Authors:
- GAMMELGARD Monica, et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 19(3), September 2008, pp.352-370.
- Publisher:
- Taylor and Francis
The aim of this study was to examine the short-term predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) in a sample of institutionalised adolescents. Subjects were 208 adolescents in general residential adolescent psychiatry, correctional schools, or adolescent forensic units. Demographic features and the information needed to assess violence risk with SAVRY were retrieved from medical files and child welfare records. Information on institutional violence was retrieved from the files for the six months after assessment (or at discharge if this occurred sooner). Validity was measured by comparing risk estimates and violent outcomes. Logistic regression analysis revealed odds ratios of 27.85 for the high risk group and 3.83 for the moderate risk group when compared to the low risk group, when adjusting the analyses for sex, age, diagnosis, service level, and time of follow-up. Based on these findings we can assume that the SAVRY is a useful and valid aid for professionals across several service levels when assessing risk of violent behaviour and intervention needs in youth with severe challenging and aggressive behaviours, even though we need further information on the impact of gender and psychopathology on violence risk in youth samples.
Sexual offending and mental health: multidisciplinary management in the community
- Editors:
- HOUSTON Julia, GALLOWAY Sarah, (eds.)
- Publisher:
- Jessica Kingsley
- Publication year:
- 2008
- Pagination:
- 288p.
- Place of publication:
- London
The contributors describe current influential models of sexual offending and the developmental, psychological and social factors involved. They discuss the prevalence of personality and mental disorders in known sex offenders and the impact these disorders have on their treatment and management. They describe clinical work with individuals, their partners and families, and also consider the impact of this work on professionals. The book includes an outline of current approaches to risk assessment, an overview of the recent changes in legislation in England and Wales, and suggestions for multi-disciplinary management in the community.
Cues and knowledge structures used by mental-health professionals when making risk assessments
- Authors:
- BUCKINGHAM Christopher D., ADAMS Ann, MACE Chris
- Journal article citation:
- Journal of Mental Health, 17(3), June 2008, pp.299-314.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Research into mental-health risks has tended to focus on epidemiological approaches and to consider pieces of evidence in isolation. Less is known about the particular factors and their patterns of occurrence that influence clinicians' risk judgements in practice. This research aims to identify the cues used by clinicians to make risk judgements and to explore how these combine within clinicians' psychological representations of suicide, self-harm, self-neglect, and harm to others. Content analysis was applied to semi-structured interviews conducted with 46 practitioners from various mental-health disciplines, using mind maps to represent the hierarchical relationships of data and concepts. Most of the participants were from psychiatric nursing (21)and psychiatry (14), but social workers (3), general practitioners (3), and psychologists (3) were also represented. Strong consensus between experts meant their knowledge could be integrated into a single hierarchical structure for each risk. This revealed contrasting emphases between data and concepts underpinning risks, including: reflection and forethought for suicide; motivation for self-harm; situation and context for harm to others; and current presentation for self-neglect. Analysis of experts' risk-assessment knowledge identified influential cues and their relationships to risks. It can inform development of valid risk-screening decision support systems that combine actuarial evidence with clinical expertise.
Psychiatric risk assessment in child and family law
- Author:
- MAHENDRA B.
- Journal article citation:
- Family Law, 38, June 2008, pp.569-571.
- Publisher:
- Jordan
Discusses the approaches that psychiatric risk assessment can take in cases involving family and child proceedings. Areas discussed include: violence against children, sexual violence and parental alienation. It is stressed that psychiatric risk assessment should be used as part of a comprehensive risk assessment including other facets of behaviour.
Forensic psychiatry and violent adolescents
- Authors:
- O'SHAUGHNESSY Roy J., ANDRADE Holly J.
- Journal article citation:
- Brief Treatment and Crisis Intervention, 8(1), February 2008, pp.27-42.
- Publisher:
- Oxford University Press
In the 1990s, increasing rates of violence among adolescents spawned a new era of research into the causes and correlates of youth violence. The resultant data on risk factors have provided opportunities for establishing empirically based assessments and risk-focused treatment programs. Community-based treatment programs that demonstrate moderate effect in reducing violence have renewed optimism in the benefit of treatment over punishment. Current research on "adolescent psychopathy" and structured assessments of risk for violence present opportunities for advancing rehabilitation but carry a significant risk of harm. It is essential that forensic psychiatrists are guided by the available evidence and instruments when providing professional opinions on violent adolescent clients to the criminal justice system. In fitting with the evidence-based practice approach, forensic psychiatrists have an ethical responsibility to take into consideration available empirical research relevant to assessing and treating violent adolescents. Current policies that limit the ability to provide treatment in juvenile settings should be challenged by organized psychiatry.
Using cumulative risk to screen for mental health problems in child welfare
- Authors:
- McCRAE Julie S., BARTH Richard P.
- Journal article citation:
- Research on Social Work Practice, 18(2), March 2008, pp.144-159.
- Publisher:
- Sage
This study tests the hypothesis that information typically collected during a maltreatment investigation can be used to screen children for mental health problems. Data are from the National Survey of Child and Adolescent Well-Being in the US was used for the study. Cumulative risk scores were created for 3,022 children and compared to reports of clinical-level problems using standardized measures. Bivariate, multivariate, and sensitivity analyses were used. Cumulative risk showed 73% sensitivity to identify children with mental health concerns and 52% specificity to identify children without such concerns. Comparatively, child welfare worker indications showed 48% sensitivity and 78% specificity. Investigative information could serve the dual purpose of screening children for mental health problems, having the potential for benefit and cost avoidance.
Risk assessment in psychiatry: a guide for lawyers
- Author:
- MAHENDRA B.
- Publisher:
- Family Law
- Publication year:
- 2008
- Pagination:
- 276p., bibliog.
- Place of publication:
- Bristol
This guidebook is designed for a non-specialist audience to understand the main concepts of in part I, the range of psychiatric orders, and in part II, risk assessment in psychiatry. The text is supported by 5 appendices detailing practice direction given by the Experts in Family Proceedings relating to children, the Disability Discrimination Act 1995 (Pt 1) and Mental Capacity Act 2005 (Pt 1), accounts of 4 court cases which illustrate key points of law and a selected bibliography. Also provided is a glossary and tables of all court cases and statutes, referenced in the text. In this book, risk assessment is defined as the evaluation of risk of aggression or untoward behaviour during proceedings, involving children, families, lawyers and other professionals. In addition, it is also viewed from the perspective of the risk of occurrence of psychiatric disorder, which has implications for employment, personal injury and mental health laws. Psychiatric topics and orders covered in detail in the 9 chapters of part I include diagnosis, intervention and treatment, dementias, schizophrenia, bipolar disorder, depression, anxiety, phobias, obsessive compulsive disorder, stress, substance misuse, gambling addiction, eating disorders, personality disorders, learning disabilities, autism, Aspergers syndrome, postnatal depression and other psychoses, and hypochondriacal neuroses such as Munchausens syndrome.
Risk, mental disorder and social work practice: a gendered landscape
- Authors:
- WARNER Joanne, GABE Jonathan
- Journal article citation:
- British Journal of Social Work, 38(1), January 2008, pp.117-134.
- Publisher:
- Oxford University Press
Whilst the importance of gender for social work practice, risk and mental health has been recognized theoretically for some time, few attempts have been made to explore this area empirically. This paper presents findings from a mixed-methods study of social work practice in relation to mental health service users perceived to be ‘high-risk’ in a social services department in the south-east of England. Findings suggest, first, that the concept ‘high-risk’ was gendered because the primary focus in social work practice was on the risks posed by male service users to others. Second, female social workers in the present study were found to have more female service users from their caseloads who had been defined as ‘high-risk’ compared with their male counterparts. The paper goes on to explore this apparent congruence between female social workers and female service users and highlights how the management of risk could be considered gendered because it reflects a worker’s (perceived) capacity in cultural terms to ‘decode’ the nature of the risks that their clients face as gendered subjects. The paper demonstrates how the intersections between risk, mental disorder and social work practice can therefore be understood as a gendered landscape. It concludes by highlighting the implications of these findings for social work practice and research.