title: Integrating service user and practitioner expertise within a web-based system for collaborative mental-health risk and safety management.
abstract: OBJECTIVE
  To develop a decision support system (DSS), myGRaCE, that integrates service user (SU) and practitioner expertise about mental health and associated risks of suicide, self-harm, harm to others, self-neglect, and vulnerability. The intention is to help SUs assess and manage their own mental health collaboratively with practitioners.
  
  
  METHODS
  An iterative process involving interviews, focus groups, and agile software development with 115 SUs, to elicit and implement myGRaCE requirements.
  
  
  RESULTS
  Findings highlight shared understanding of mental health risk between SUs and practitioners that can be integrated within a single model. However, important differences were revealed in SUs' preferred process of assessing risks and safety, which are reflected in the distinctive interface, navigation, tool functionality and language developed for myGRaCE. A challenge was how to provide flexible access without overwhelming and confusing users.
  
  
  CONCLUSIONS
  The methods show that practitioner expertise can be reformulated in a format that simultaneously captures SU expertise, to provide a tool highly valued by SUs. A stepped process adds necessary structure to the assessment, each step with its own feedback and guidance.
  
  
  CONCLUSIONS
  The GRiST web-based DSS (www.egrist.org) links and integrates myGRaCE self-assessments with GRiST practitioner assessments for supporting collaborative and self-managed healthcare.
authors: Computer Science, Aston University, Aston Triangle, Birmingham B4 7ET, UK. Electronic address: c.d.buckingham@aston.ac.uk.
authors: Christopher D
authors: CD
authors: Buckingham
authors: Division of Mental Health and Wellbeing, University of Warwick, Coventry, UK. Electronic address: a.e.adams@warwick.ac.uk.
authors: Ann
authors: A
authors: Adams
authors: Division of Mental Health and Wellbeing, University of Warwick, Coventry, UK. Electronic address: laura.vail@warwick.ac.uk.
authors: Laura
authors: L
authors: Vail
authors: Computer Science, Aston University, Birmingham, UK. Electronic address: kumara4@aston.ac.uk.
authors: Ashish
authors: A
authors: Kumar
authors: Computer Science, Aston University, Birmingham, UK. Electronic address: ahmeda10@aston.ac.uk.
authors: Abu
authors: A
authors: Ahmed
authors: Mental Health Providers' Forum, London, UK. Electronic address: anniewhelan@aol.com.
authors: Annie
authors: A
authors: Whelan
authors: Institute of Digital Healthcare, University of Warwick, Coventry, UK. Electronic address: e.karasouli@warwick.ac.uk.
authors: Eleni
authors: E
authors: Karasouli
mesh_terms: D003299:Cooperative Behavior; D020000:Decision Support Systems, Clinical; D017144:Focus Groups; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D008603:Mental Health; D008605:Mental Health Services; D018570:Risk Assessment; D017751:Safety Management; D012648:Self Care; D012985:Software Design; D014584:User-Computer Interface
keywords: Clinical decision support systems; Cognitive modelling; Collaborative healthcare; GRaCE; GRiST; Mental health; Risk assessment; Self-management