title: Surveying clinician perceptions of risk assessment and management practices in mental health service provision.
abstract: OBJECTIVE
  This study aimed to survey multidisciplinary mental health staff on their perceptions of risk assessment and management practices in a local health district in Sydney.
  
  
  METHODS
  The research team developed the risk assessment and management survey (RAMS) which was distributed to staff across the district from November 2013 to January 2014.
  
  
  RESULTS
  A total of 340 RAMS were distributed and 164 were returned (48% response rate). There was considerable agreement that risk assessment and management is essential to maintaining safety and delivering good mental health care, and respondents reported high levels of confidence in their judgement when carrying out such practices. Respondents identified organisational pressure in relation to risk assessment and management but also felt supported. However, 65% of respondents considered that there 'is good evidence that risk assessment and management practices are effective in reducing risk in mental health care', when this is not the case.
  
  
  CONCLUSIONS
  The confidence that clinicians placed in risk assessment and management practices (despite an absence of evidence) is disconcerting. Given the dominance of risk assessment and management, health services mandating such practices have a duty to inform employees of the current evidence base for this approach in reducing risk.
authors: Associate Professor, University of Sydney and Sydney Local Health District, Concord, NSW, and; Nurse Practitioner, Mental Health Liaison, Emergency Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia timothy.wand@sswahs.nsw.gov.au.
authors: Timothy
authors: T
authors: Wand
authors: Grad Cert, Child and Family Health, Clinical Nurse Consultant, Quality and Research, Sydney Local Health District, Concord, NSW, Australia.
authors: Sophie
authors: S
authors: Isobel
authors: Grad Cert, Mental Health, Clinical Nurse Consultant, Mental Health Liaison, Emergency Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
authors: Kate
authors: K
authors: Derrick
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D018570:Risk Assessment; D012308:Risk Management; D011795:Surveys and Questionnaires
keywords: attitude of health personnel; culture of blame; dignity of risk; risk assessment and management; risk aversion