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Investigating mental health risk assessment in primary care and the potential role of a structured decision support tool, GRiST.

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Vail, Laura, Adams, Ann, Gilbert, Eleanor, Nettleingham, A. and Buckingham, Christopher D. (2012) Investigating mental health risk assessment in primary care and the potential role of a structured decision support tool, GRiST. Mental Health in Family Medicine, 9 (1). pp. 57-67. PMC3487610.

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Abstract

Aim To explore current risk assessment processes in general practice and Improving Access to Psychological Therapies (IAPT) services, and to consider whether the Galatean Risk and Safety Tool (GRiST) can help support improved patient care.

Background Much has been written about risk assessment practice in secondary mental health care, but little is known about how it is undertaken at the beginning of patients' care pathways, within general practice and IAPT services.

Methods Interviews with eight general practice and eight IAPT clinicians from two primary care trusts in the West Midlands, UK, and eight service users from the same region. Interviews explored current practice and participants' views and experiences of mental health risk assessment. Two focus groups were also carried out, one with general practice and one with IAPT clinicians, to review interview findings and to elicit views about GRiST from a demonstration of its functionality. Data were analysed using thematic analysis.

Findings Variable approaches to mental health risk assessment were observed. Clinicians were anxious that important risk information was being missed, and risk communication was undermined. Patients felt uninvolved in the process, and both clinicians and patients expressed anxiety about risk assessment skills. Clinicians were positive about the potential for GRiST to provide solutions to these problems.

Conclusions A more structured and systematic approach to risk assessment in general practice and IAPT services is needed, to ensure important risk information is captured and communicated across the care pathway. GRiST has the functionality to support this aspect of practice.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Mental health , Primary health care , Health risk assessment
Journal or Publication Title: Mental Health in Family Medicine
Publisher: Radcliffe Publishing Ltd.
Official Date: January 2012
Dates:
DateEvent
January 2012Published
February 2012Accepted
Volume: 9
Number: 1
Page Range: pp. 57-67
Article Number: PMC3487610
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Funder: Primary Care Research Network (PCRN), National Institute for Health Research (Great Britain) (NIHR)
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