Risk Management In Mental Health Services Page 40
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544.3 Key Clinical Risks
As identified in Chapter One the four areas of risk which are relevant for
consideration when managing people with mental health issues (O’Rourke
and Hammond, 2005) are;
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, and homelessness) or other
resource or capability issues. There needs to be a greater awareness of
risks of sexual vulnerability of mental health inpatients, to cover both
patient’s own behaviour and the advances of others;
Self harm/suicide risk:
The service user can be at risk from self harm,
intentional injury or killing oneself, action/behaviours destructive to one’s
own safety or health;
Mental instability:
The service user can be a risk to self or others
because of fluctuating and/or unpredictable mental health function
especially in relation to command hallucinations and other “at risk”
psychotic or disturbed phenomena;
Risk to others:
The service user can be at risk of causing harm or danger to
others or encouraging/involving others in the causing of harm or injury to others
4.3.1
Vulnerability and Mental Instability
The recovery process involves some exposure to risk. Growth takes place
by encountering different circumstances and/or relationships and risk is
part of these changes. Risk may be minimised by a profe s s i o n a l
awareness of vulnerability factors and impending mental instability.
Good clinical practice includes risk assessment and management which
takes cognisance of vulnerability factors. Ultimately this leads to the
minimising of risk to self and others. Mental instability can be managed
more effectively by early recognition.
As well as following the steps of clinical risk assessment outlined in Chapter
Three, the following parameters should be considered in assessing for
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indication of vulnerability or mental instability (this is not an exhaustive list):
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