(Press-News.org) The assessment of risk in patients who go on to die by suicide or commit homicide is often poor, a new study has found.
A report by The University of Manchester's National Confidential Inquiry (NCI) into Suicide and Homicide by People with Mental Illness out today has raised concerns about the way that risk is assessed and led to criticism of the tick-box approach to clinical practice.
Researchers looked at a sample of 81 cases where risk had been judged to be low, but seven days or less after the assessment the patient died by suicide or committed homicide, to retrospectively address the quality of the assessments. They found that in about a third of the cases (36% of the patient suicides and 41% or the patient homicides) the overall quality of risk assessment was unsatisfactory. In the majority of cases, however, risk assessment and management were satisfactory, even though they were followed within seven days by a fatal incident.
Professor Louis Appleby, commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of the NHS England, NHSSPS Northern Ireland, the Scottish Government, the Welsh Government and the Channel Islands, said: "The results suggest there is a need for risk management to be individually tailored, or personalized, to each patient rather than following a "tick-box" approach.
"In the majority of the 81 sample cases studied risk assessment and management were satisfactory, but in a significant minority of cases we studied we found clinical risk assessment and management may not have been adequate. This is an uncomfortable conclusion for clinicians but one that should lead to improvements.
"In a small but significant number of cases, even when risk was recognized, appropriate management did not follow, for example patients were granted unescorted leave within a few hours of detention for acute psychosis. This could be the consequence of a "tick-box" approach to risk assessment, something that has been widely criticized by clinicians."
Professor Appleby, from the University's Centre for Behaviour and Mental Health who is also part of Manchester Mental Health and Social Care Trust, said the risk factors associated with suicide and serious violence in mental illness were well documented. Previous studies show one in four people who die by suicide have a history of recent contact with mental health services and one in 10 who commit homicide.
The researchers developed a framework for evaluating the quality of risk assessment and management in mental health patients based on existing best practice guidelines which included taking into account the patient's history, mental state and current circumstances, an overall judgment of the risk factors, a management plan, communication of the management plan and overall quality of assessment.
Unsatisfactory assessments before a homicide were often associated with a diagnosis of personality disorder or alcohol misuse.
The report authors hope that services will now use the framework and key principles set out in the report to examine their own processes, in particular that of individual risk assessment formulation followed by personalized risk management. Further studies should focus on assessment of patients with personality disorder, look at more cases using the framework, Professor Appleby added.
INFORMATION:
Patient suicide and homicide risk often missed say researchers
The assessment of risk in patients who go on to die by suicide or commit homicide is often poor, a new study has found
2013-06-26
ELSE PRESS RELEASES FROM THIS DATE:
Major rethink needed if chemical industry is to meet greenhouse gas targets
2013-06-26
The UK chemical industry requires 'an urgent and radical rethink' into how it produces chemicals if it is to play its part in meeting Government's stringent greenhouse gas emission reduction targets of 80% plus by 2050.
That is one of the conclusions of a major new report issued today by the University of Manchester's Tyndall Centre for Climate Change Research. Entitled 'Can the UK afford (not) to produce chemicals in 2050?' the report was generated in collaboration with the North East Process Industry Cluster (NEPIC) following investigations into chemical sector greenhouse ...
Exaggeration, exaggeration, exaggeration: Parties over-egg claims on education
2013-06-26
Exaggeration, exaggeration, exaggeration: parties over-egg claims on education
Both major political parties have overstated their claims and counter-claims on education, according to an independent review of Labour's record in office.
The report, led by Professor Anthony Heath from The University of Manchester, says governments mostly fail to introduce policies which can be rigorously evaluated.
The report, published this month in the Oxford Review of Economic Policy, praises Labour 's policy on further education and Education Maintenance Allowance.
The Blair and ...
Complex genetic architectures: Some common symptoms of trisomy 21
2013-06-26
Down syndrome, more commonly known as "trisomy 21" is very often accompanied by pathologies found in the general population: Alzheimer's disease, leukemia, or cardiac deficiency. In a study conducted by Professor Stylianos Antonarakis' group from the Faculty of Medicine of the University of Geneva (UNIGE), researchers have identified the genomic variations associated with trisomy 21, determining the risk of congenital heart disease in people with Down syndrome. The targeted and specific study of chromosome 21 revealed two genomic variations, which, in combination, are the ...
Bladder function restored in animals with severe spinal cord injury
2013-06-26
For the first time, researchers have restored significant bladder function through nerve regeneration in rats with the most severe spinal cord injuries (SCI). The breakthrough paired a traditional nerve bridge graft with a novel combination of scar degrading and growth factor treatments to grow new nerve cells from the thoracic level to the lower spinal cord region. Details of the discovery appear in the June 26 issue of the Journal of Neuroscience.
Neuroscientists from Case Western Reserve University School of Medicine and Cleveland Clinic built a regeneration bridge ...
Virtual skin model reveals secrets of skin aging
2013-06-26
We constantly grow new skin and slough off the old. Until now, scientists have never agreed on exactly how this works, but new research from the University of Sheffield may provide the answer.
Engineers and biologists at the University of Sheffield have shown how a recent theory-- that skin has 'sleeping' stem cells which can be woken up when required-- best explains how our skin constantly regrows. The research-- conducted in collaboration with The Procter & Gamble Company (P&G), makers of Olay, and published in Nature Scientific Reports-- has implications for combating ...
Teenage physical fitness reduces the risk of suicidal behavior later in life
2013-06-26
Being in good physical shape at 18 years of age can be linked with a reduced risk of attempted suicide later in life. So says a study of over one million Swedish men conducted by researchers at the Sahlgrenska Academy, University of Gothenburg, Sweden.
A new, extensive report from the Swedish National Board of Health and Welfare on child and adolescent health shows that teenagers and young adults in Sweden have worse mental health than their age cohorts in other western countries.
Another report that is part of a new social welfare study shows that the number of serious ...
Sailors most often injure their knees -- on land
2013-06-26
The knees are the body part that is injured the most by dinghy sailors. The injuries are primarily due to overstrain and most often occur during physical training. This was shown in a study at Sahlgrenska Academy, University of Gothenburg, Sweden.
"Studies have been made on the risk of injury for many sports, but not for dinghy sailing. With more knowledge, we can create recommendations that will prevent sailors from getting injured," says Lena Bøymo-Having, who conducted the study at the Sahlgrenska Academy, University of Gothenburg.
During the study, researchers followed ...
Having a job helps women with HIV manage their illness, according to new research
2013-06-26
Having a job helps women with HIV manage their illnesses, according to researchers from Case Western Reserve University and the University of California at San Francisco.
The routine of a work schedule, plus the job-related money and benefits, provides extra emotional support for these women, said Allison Webel, assistant professor of nursing at Case Western Reserve University's Frances Payne Bolton School of Nursing and the study's lead author.
Findings in the National Institutes of Health-supported study were published this month in Social Science & Medicine.
The ...
Songbirds turn on and tune up
2013-06-26
Bullfinches learn from human teachers to sing melodies accurately, according to a new study by the late Nicolai Jürgen and researchers from the University of Kaiserslautern in Germany. Their analysis of human melody singing in bullfinches gives insights into the songbirds' brain processes. The work is published online in Springer's journal Animal Cognition.
Music performance is considered to be one of the most complex and demanding cognitive challenges that the human mind can undertake. Melody singing requires precise timing of several organized actions as well as accurate ...
New research: Wolf Lake ancient forest is endangered ecosystem
2013-06-26
New research from the University of Guelph, published Tuesday in the journal Biodiversity and Conservation, says that allowing industrial extraction in a northern Ontario old-growth red pine forest – the largest remaining in the world – would significantly threaten biodiversity in Canada.
The study says that Wolf Lake Forest Reserve is a "scientifically irreplaceable system."
"Wolf Lake Forest deserves intensive study, monitoring and full protection from future development," said Guelph environmental sciences professor Madhur Anand, the study's lead author.
Old-growth ...
LAST 30 PRESS RELEASES:
Sensitive ceramics for soft robotics
Trends in hospitalizations and liver transplants associated with alcohol-induced liver disease
Spinal cord stimulation vs medical management for chronic back and leg pain
Engineered receptors help the immune system home in on cancer
How conflicting memories of sex and starvation compete to drive behavior
Scientists discover ‘entirely unanticipated’ role of protein netrin1 in spinal cord development
Novel SOURCE study examining development of early COPD in ages 30 to 55
NRL completes development of robotics capable of servicing satellites, enabling resilience for the U.S. space infrastructure
Clinical trial shows positive results for potential treatment to combat a challenging rare disease
New research shows relationship between heart shape and risk of cardiovascular disease
Increase in crisis coverage, but not the number of crisis news events
New study provides first evidence of African children with severe malaria experiencing partial resistance to world’s most powerful malaria drug
Texting abbreviations makes senders seem insincere, study finds
Living microbes discovered in Earth’s driest desert
Artemisinin partial resistance in Ugandan children with complicated malaria
When is a hole not a hole? Researchers investigate the mystery of 'latent pores'
ETRI, demonstration of 8-photon qubit chip for quantum computation
Remote telemedicine tool found highly accurate in diagnosing melanoma
New roles in infectious process for molecule that inhibits flu
Transforming anion exchange membranes in water electrolysis for green hydrogen production
AI method can spot potential disease faster, better than humans
A development by Graz University of Technology makes concreting more reliable, safer and more economical
Pinpointing hydrogen isotopes in titanium hydride nanofilms
Political abuse on X is a global, widespread, and cross-partisan phenomenon, suggests new study
Reintroduction of resistant frogs facilitates landscape-scale recovery in the presence of a lethal fungal disease
Scientists compile library for evaluating exoplanet water
Updated first aid guidelines enhance care for opioid overdose, bleeding, other emergencies
Revolutionizing biology education: Scientists film ‘giant’ mimivirus in action
Genetic variation enhances cancer drug sensitivity
Protective genetic mutation offers new hope for understanding autism and brain development
[Press-News.org] Patient suicide and homicide risk often missed say researchersThe assessment of risk in patients who go on to die by suicide or commit homicide is often poor, a new study has found