Structured risk assessment for reduction of multiple risk outcomes in a secure mental health setting:use of the START
Background: Structured risk assessment is commonly used in secure settings to aid prediction and prevention of risky behaviours; the expected benefits have rarely been investigated. Aims: The aim of the study is to determine whether adverse outcomes (physical and verbal aggression, self-harm, victim...
| Authors: | ; ; |
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| Format: | Electronic Book |
| Language: | English |
| Published: |
2018
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| In: | Year: 2018 |
| Online Access: |
Volltext (kostenfrei) Volltext (kostenfrei) |
| Check availability: | HBZ Gateway |
| Keywords: |
| Summary: | Background: Structured risk assessment is commonly used in secure settings to aid prediction and prevention of risky behaviours; the expected benefits have rarely been investigated. Aims: The aim of the study is to determine whether adverse outcomes (physical and verbal aggression, self-harm, victimisation, self-neglect, unauthorised leave and substance abuse) reduced after patients were assessed with the Short-term Assessment of Risk and Treatability (START). Methods: In a naturalistic study, anonymised demographic and clinical information was collected from 50 male patients. Data included START assessment and frequency of target behaviour for 3 months before and after first assessment. Chi-square and linear mixed models analyses were used to determine whether there was any change in the behaviours of interest. Results: There were no significant changes in physical or verbal aggression over time, although a tendency towards fewer incidents was apparent. Other adverse behaviours were very infrequent at baseline, precluding adequate analysis. Conclusions: In this small sample, START did not achieve its primary purpose of significant reduction in adverse behaviours. Although our sample size was informed by a power calculation, we may have over-estimated the size of anticipated change. Further, the 3-month comparison periods before and after the assessment follow-up period were rather short. Accordingly, we recommend more research on the value of this tool in practice rather than discontinuing its use |
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| DOI: | 10.1002/cbm.2036 |