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Cues and knowledge structures used by mental-health professionals when making risk assessments

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Buckingham, C. D., Adams, Ann and Mace, Chris. (2008) Cues and knowledge structures used by mental-health professionals when making risk assessments. Journal of Mental Health, Vol.17 (No.3). pp. 299-314. ISSN 0963-8237

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Official URL: http://dx.doi.org/10.1080/09638230701498374

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.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry B Philosophy. Psychology. Religion > BF Psychology
Divisions:	Faculty of Medicine > Warwick Medical School > Mental Health and Wellbeing Faculty of Science > Psychology Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Mental health -- Research, Risk assessment, Self-mutilation
Journal or Publication Title:	Journal of Mental Health
Publisher:	Taylor & Francis
ISSN:	0963-8237
Date:	2008
Volume:	Vol.17
Number:	No.3
Page Range:	pp. 299-314
Identification Number:	10.1080/09638230701498374
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Description:	Version accepted by publisher (post-print, after peer review, before copy-editing).
Funder:	Great Britain. National Health Service (NHS), Great Britain. Dept. of Health (DoH)
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URI:	http://wrap.warwick.ac.uk/id/eprint/177