Risk Management In Mental Health Services Page 11
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54In the HSE risks of all kinds should be systematically identified, evaluated,
assessed and managed in order of priority. The principal vehicle for
identifying, communicating and tracking risk at all levels is the risk register,
which allows a repository of risk information to be maintained (HSE,
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2007). Guidance on conducting risk assessment
and developing the risk
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register has been prepared by the HSE and is available (HSE, 2008).
1.5 Concept of Risk and Mental Health Service
Provision
Part of the work of mental health professionals, whether in community or
hospital based multidisciplinary teams, is to manage risk. Risk is often
perceived as a wholly negative process. As a consequence of this negative
perception “individuals and organisations often take a ‘fight or flight’
a p p r o a ch to risk assessment and management. The former is
characterized by over reaction, rigidity, excessive controls and the
identification of risk where none may exist. The latter can involve
avoidance, complacency or the denial and minimization of risk. Anxiety
and other emotions can therefore exert a significant influence on risk
assessment management and strategy practice and policy.”
(O’Rourke and Bailes, 2006).
This negative view is not a productive way of viewing risk. Whilst it can be
linked with the concepts of harm or danger, risk also can be a chance to
gain benefits in a situation where harm is possible (Gilmore, 2004). It is
important to be clear about what we mean when we examine risk in
relation to mental health issues.
Four areas of risk are relevant for consideration when dealing with people
with mental health issues;
Vulnerability:
The service user can be at risk of or exposed to damage
or harm through personal or external factors (e.g. naiveté, low insight,
family, social/community pressures, in care, poverty, homelessness or
other resource or capability deficits);
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HSE (2008) Risk Assessment Tool and Guidance (including guidance on application) Office of Quality and
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Risk.
HSE (2007) Developing a populating a Risk Register Best Practice Guidance. Office of Quality and
R i s k .
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