Synopsis

Mental health risk assessments have always been a challenge, even for the most experienced clinicians. Risk assessment involves understanding not just the severity of the reported symptoms but the underlying motivations and the psychosocial circumstances.  This includes the drivers, the precipitating factors, and the interactions between the various risks within an individual, which can include risk of suicide, self-harm, violence and aggression, or other neurodevelopmental and psychosocial vulnerability and crisis.

The way risk is estimated in mental health clinical practice is by using rating scales that result in the categorisation of risk into low, moderate, and high, which informs care and treatment. Research has shown that this form of risk categorization does not have firm scientific basis. International guidelines have suggested the creation of a method of risk screening, assessment and management that is based in a fuller understanding of the individual patient’s unique circumstances, and formulating the risk to inform mitigation plans. This is a major shift within mental health which is being implemented within RCH. This presentation will outline the challenges with mental health risk assessments and how a project currently underway in mental health seeks to modernise the way risk is assessed and managed.

Speaker

Dr Chidambaram Prakash is the Director of Mental Health at The Royal Children’s Hospital. Prakash is a child and adolescent psychiatrist of 25 years’ experience with special interests in neurodevelopmental disorders, neuropsychiatry, acute and consultation psychiatry. Prakash is leading a reform process in RCH Mental Health to modernise the risk management system and extend risk assessments beyond suicide, self-harm and aggression to include developmental and psychosocial risks. This will have wide reaching impact on mental health and behavioural risk assessments in clinical practice across RCH.