How to Improve Clinician’s Confidence and Competence in Risk Assessment
Melanie Newton1, Kirsty Stewart1,21Royal Perth Bentley Group, Perth, WA, Australia2Curtin University, Perth, WA, Australia
Abstract
In 2021, 389 individuals died by suicide in WA. For every suicide death, as many as 25 people will attempt suicide. In clinical populations, suicidal behaviours are future events that should be the focus of prevention. A key factor in prevention is the identification and engagement of people with suicidal thoughts and behaviours. Currently, it is common practice within mental health settings for risk assessments to classify individuals as high, medium or low risk for future suicidal behaviours. This classification (stratification) is used to determine the allocation of after-care aimed at preventing these behaviours. The high-risk stratum are generally offered specific interventions (for instance, inpatient admission, close nursing observation [for inpatients], face-to-face or telephone follow-up and identified community support) or more intense intervention (for instance, greater frequency of reviews in inpatient and community settings). Risk stratification is widely practiced and endorsed. This is despite the majority of suicides (60%) occurring in people assessed as being at low risk. This inaccuracy of suicide prediction and planning has been known for over 60 years and yet it persists in our mental health services. A review of Severity Assessment Code clinical incidents in our service found a root cause of many deaths was the quality of risk assessment conducted. We introduced a training program based on best practice and evaluated attendees confidence and competency pre- and post-attending the program. The findings indicate significant change in clinicians’ confidence and competence following attendance. Findings and next steps will be presented.
Biography
Dr Newton has developed and facilitated many training programs including ARSP and Coaching for Leaders. She has 15 years experience in both public and private settings and is passionate about ongoing learning.
Kirsty Stewart is a Senior Social Worker with a Masters of Criminology and 15 years of experience in academic, forensic, and health settings; she has led the delivery of ARSP since 2021. Her desire to improve mental health services for the most vulnerable consumers has led her to PhD research; the project will develop a localised plan for the systemic reform of care provided to suicidal people.