Self-Harm and Violence: Towards Best Practice in Managing Risk in Mental Health Services

Self-Harm and Violence: Towards Best Practice in Managing Risk in Mental Health Services

Self-Harm and Violence: Towards Best Practice in Managing Risk in Mental Health Services

Self-Harm and Violence: Towards Best Practice in Managing Risk in Mental Health Services

Synopsis

Self-Harm and Violence: Towards Best Practice in Managing Risk in Mental Health Services presents the first exploration of the most effective clinical practice techniques relating to the management of risk in mental health care settings.
  • Based on the Department of Health's Best Practice in Managing Risk guidance document, which was developed over a 12-month period in consultation with a national expert advisory group
  • Features contributions from many members of the group that drew up the Best Practice document - all leading theoreticians and practitioners in their particular fields - and embeds the principles laid out in the guidelines in real world practice
  • Reveals how contemporary risk management is a multidisciplinary and collaborative enterprise in which practitioners from different professions need to engage with each other in order to achieve success

Excerpt

Safety is at the centre of all good health care. However, in mental health, safety can be particularly sensitive and challenging. The autonomy and rights of service users have to be considered alongside risk to the public. A good therapeutic relationship must, therefore, include both sympathetic support and objective assessment of risk.

In the last decade, there have been a number of initiatives that are intended to make mental health services safer. Assertive outreach teams, for example, now provide intensive care in the community to people who may drift away from care, putting themselves and others at risk. Also, more acceptable treatments, both modern drugs and psychological therapies, are more widely available. The Care Programme Approach has recently been revised to align it more closely to the management of risk. And, to back up these changes, the Mental Health Act has been amended in various ways.

We know from the work of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness that staff have often found it difficult to recognize risk in cases where a suicide or a homicide occurs. There are complex reasons for this, to do with our training as frontline professionals, the relationships we try to make with service users and the inherent difficulties in understanding and positively managing risk as part of a collaborative venture.

This book offers a positive message and practical guidance on what can be done to improve our understanding of risk and what we can usefully do to manage it. It is unrealistic to expect services to prevent all incidents of harm to self and others, but the clinical management of risk can always be strengthened, with benefits to service users and their families, to the public and to the public perception of mental health services.

Louis Appleby National Clinical Director for Health and Criminal Justice May 2010

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