Principles of Mental Health Risk Assessment

Overview

Risk assessment is a foundation skill for mental health clinical practice. But, risk assessments tools have a number of limitations. There is a need for standardised risk assessment. In this paper, the Office of the Chief Psychiatrist aims to offer guidance to service providers in the context of the tensions that arise as a result. This paper describes an evidence-based approach to risk to inform thinking in the mental health sector. It describes the key shared principles of risk formulation and mitigation for the sector and explains clinical approaches for non–mental health people who want to understand how decisions about risk are reached.

Key insights

The key insights are that:

1. Risk is dynamic
2. Risk is impacted by connection and relationship
3. Risk is impacted by population and context
4. Overall risk is a balance between short-term and long-term risks
5. Consider undertaking a risk-benefit analysis
6. Therapeutic risk taking is important to elevate agency and long-term recovery
7. Identifying strengths, supports and believes is protective
8. Operational or situational constraints may also impact risk
9. Decision-making about risk should be readily escalated in clinical settings