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

Chris D. Buckingham, Ann Adams, Chris Mace

Research output: Contribution to journalArticle

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.
Original languageEnglish
Pages (from-to)299-314
Number of pages16
JournalJournal of mental health
Volume17
Issue number3
DOIs
Publication statusPublished - Jun 2008

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Cues
Mental Health
Suicide
Motivation
Consensus
Interviews
Psychology
Research

Keywords

  • mental-health risks
  • epidemiological approaches
  • risk judgements
  • suicide
  • self-harm
  • self-neglect
  • and harm to others
  • mind maps

Cite this

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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.",
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Cues and knowledge structures used by mental-health professionals when making risk assessments. / Buckingham, Chris D.; Adams, Ann; Mace, Chris.

In: Journal of mental health, Vol. 17, No. 3, 06.2008, p. 299-314.

Research output: Contribution to journalArticle

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