How mental health clinicians assess and manage the risk of violence from mental health consumers: a descriptive exploratory research investigation

Abstract

The advent of deinstitutionalisation has increased the number of mental health consumers in the community. Consequently, community mental health clinicians (CMHC) now play an increasingly important role in caring for mental health consumers, which raises the question of how CMHCs maintain their safety. The overall aim of the research was to improve the safety of CMHCs when caring for mental health consumers. In light of this question, a literature search was conducted to investigate how CMHCs assess and manage the risk of violence from mental health consumers in the community. The literature search provided background information about deinstitutionalisation but also revealed there was a paucity of research about the subject of risk assessment and management by CMHCs. This research was conducted to gain an understanding of the strategies of risk assessment and management in community mental health. A descriptive exploratory qualitative research methodology was selected. The research was conducted in a community mental health centre in a metropolitan region of South Australia. Individual interviews of eleven CMHCs provided data, which was thematically analysed and interpreted. The main themes that emerged were: preparing to meet the consumer; intervention strategies for safety; and organisational management. There were several strategies that were consistently upheld by CMHCs such as gaining information about a consumer; appraisal of the environment; careful attention to exit strategies; and appropriate interaction with the consumer according to their mental state. Concurrently, the research findings raised awareness of the need for improvement in certain areas relating to: communication within the team; training requirements for CMHCs; and awareness of the policies and procedures and Work Health and Safety Standards. This research has also highlighted new areas of interest for future research.