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Gurpal

Online Essay Club: Essay No. 7 of 10

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Q: 'What do you understand by the term 'risk assessment'? With reference to the literature, describe how you would assess risk in patients on mental health wards.'

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Intro

why needed

Psychiatry coming in the comunity

gen public more aware

more prejduice

actual no of incidents happening/reported

Media

Dynamic concept

diff to dangerousness

not an exact science

very difficult to predict

always changing

different meanings in diff settings and contexts

not just violence and suicide

followed closely by risk management

multidisciplinary approach vs actuarial approach

psychopathy checklist,HCR 20

different wards acute/forensic/community setting needs

actual need of it

better pt mx

Clinical governance needs

identify the needs of the pt

formulate plans for them

Its here to stay

think in its terms

keep reviewing the assessment

gives the team a sense of cohesion and unity

few references

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Risk Assessment.

1. As mentioned above, not an exact science, being akin to fortune telling.

2. In acute intensive care situatons at heart it's constant consideration of risks of;

absconsion

self or other harm. (penal model).

3. In a wider sense consideration of compliance/recurrence likeliness post discharge.

4. Also an aspect of preventative medicine in the widest sense.

5. Note that it can be ethically dubious to act on persons before they actually do anything wrong, based on political or other non theraputic rationales and perceptions of these persons (refferences;1984

Brave New World etc.)

5.5 Unless a psychiatrist is doing it, in which case it's ok.

6. One method of assessing risk is to ask them constantly about their intention with regards to above basic risks. Then write down what they say and act accordingly.

7. Wider action requires looking at the history over years and projecting a trajectory of some sort to and patterns apparent. Once more Action must be coupled to risk assessment to give it any meaning. As well as rigorously detailed and legible reporting in the notes.

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