Citation

Buckingham CD, Adams A, MacE C. J. Ment. Health 2008; 17(3): 299-314.

Copyright

(Copyright © 2008, Informa Healthcare)

DOI

10.1080/09638230701498374

PMID

unavailable

Abstract

BACKGROUND: 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. 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.

METHOD: 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.

RESULTS: 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.

CONCLUSIONS: 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. Declaration of interest: This research was funded by a NHS NEAT grant. © Shadowfax Publishing and Informa UK Ltd.

Language: en

Keywords

attitude; human; cognition; violence; mental health; suicide; Risk assessment; Mental health; depression; personality; suicidal behavior; risk assessment; Qualitative research; content analysis; association; motivation; article; mental disease; disease association; clinical article; automutilation; paranoia; patient coding; high risk behavior; family history; social environment; verbal behavior; clinical decision making; clinical competence; auditory hallucination; social dominance; mental health care personnel; semi structured interview; psychological model; self neglect; hygiene; decision support system; professional knowledge; Psychological model