{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:55:21Z","timestamp":1790924121585,"version":"4.1.0"},"reference-count":40,"publisher":"Royal College of Psychiatrists","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych Bull"],"abstract":"<jats:sec id=\"S2056469426102836_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Risk assessment and management are key elements of clinical practice in mental health. Existing literature on risk assessment in mental health has focused more on the predictive validity of tools and less on the clinical utility of tools in daily practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056469426102836_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To explore risk assessment and management processes, and how clinicians use risk tools in daily practice, across a single health board.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056469426102836_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This was a large mixed-methods study in a health authority responsible for the care of 1.3 million people covering a wide range of settings. Data collection involved multiple approaches including staff surveys, focus groups, non-participant observations of team meetings, case-file audits and reviews of incident reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056469426102836_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Although risk was routinely discussed in team meetings, the risk tool was rarely used to inform decision-making. Barriers to meaningful use of the tool included time constraints, lack of training and perceived lack of relevance. Both staff and carers reported limited involvement of patients and families in risk assessment processes. Case-file audits showed high completion rates of the risk tool but little evidence that it influenced decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056469426102836_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates a significant challenge for services, with clinical teams discussing risk but not using the mandated formulation-based risk tool to do so. This is set against the need for health authorities to demonstrate consistent standards in risk management across specialties and settings and to have a format that makes risk management plans easily available to clinicians unfamiliar with the patient. Further research is required to develop a method of recording risk mitigation strategies that is collaborative and can be easily completed in a clinical setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjb.2026.10283","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:42:31Z","timestamp":1790923351000},"page":"1-14","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Investigating risk assessment and management processes"],"prefix":"10.1192","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0790-4822","authenticated-orcid":false,"given":"Heather","family":"Tolland","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/049prb569","id-type":"ROR","asserted-by":"publisher"}],"name":"NHS Greater Glasgow and Clyde"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Drysdale","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/049prb569","id-type":"ROR","asserted-by":"publisher"}],"name":"NHS Greater Glasgow and Clyde"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"McCahon","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Mackenzie","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/049prb569","id-type":"ROR","asserted-by":"publisher"}],"name":"NHS Greater Glasgow and Clyde"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Mohammad","sequence":"additional","affiliation":[{"name":"NHS Lanarkshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Rae","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Sunderland","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Swift","sequence":"additional","affiliation":[{"name":"NHS Ayrshire and Arran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonya","family":"Sheridan","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hollie","family":"Walker","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Gillatt","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/049prb569","id-type":"ROR","asserted-by":"publisher"}],"name":"NHS Greater Glasgow and Clyde"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"S2056469426102836_ref22","volume-title":"Mental Health Strategy for Scotland: 2012\u20132015","year":"2012"},{"key":"S2056469426102836_ref24","volume-title":"Briefing Paper for Community of Practice \u2013 February 2016","year":"2016"},{"key":"S2056469426102836_ref29","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.001312012"},{"key":"S2056469426102836_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/inm.13458"},{"key":"S2056469426102836_ref8","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2008.59.2.191"},{"key":"S2056469426102836_ref7","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.177.4.303"},{"key":"S2056469426102836_ref12","doi-asserted-by":"publisher","DOI":"10.1080\/00048670701213237"},{"key":"S2056469426102836_ref38","doi-asserted-by":"publisher","DOI":"10.1192\/bjb.2020.14"},{"key":"S2056469426102836_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.114711"},{"key":"S2056469426102836_ref14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2850.2005.00885.x"},{"key":"S2056469426102836_ref15","volume-title":"Report on the Glasgow Risk Screen Clinical Record Audit","author":"Clarke","year":"2006"},{"key":"S2056469426102836_ref25","volume-title":"Briefing Paper for Community of Practice \u2013 June 2016","year":"2016"},{"key":"S2056469426102836_ref13","first-page":"131","article-title":"Assessing violence risk in general adult psychiatry","volume":"29","author":"Higgins","year":"2005","journal-title":"Psychiatrist"},{"key":"S2056469426102836_ref35","doi-asserted-by":"publisher","DOI":"10.2196\/32347"},{"key":"S2056469426102836_ref40","doi-asserted-by":"publisher","DOI":"10.1177\/00048674221107316"},{"key":"S2056469426102836_ref31","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"S2056469426102836_ref1","volume-title":"Best Practice in Managing Risk","year":"2009"},{"key":"S2056469426102836_ref18","doi-asserted-by":"publisher","DOI":"10.1108\/JMHTEP-03-2019-0016"},{"key":"S2056469426102836_ref11","volume-title":"Safety First: Five-Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness","author":"Appleby","year":"2001"},{"key":"S2056469426102836_ref28","doi-asserted-by":"publisher","DOI":"10.1108\/20420921111186598"},{"key":"S2056469426102836_ref23","volume-title":"Suicide Reporting System Learning and Improvement Review","year":"2012"},{"key":"S2056469426102836_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(20)30381-3"},{"key":"S2056469426102836_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114758"},{"key":"S2056469426102836_ref39","doi-asserted-by":"publisher","DOI":"10.1192\/bji.2025.9"},{"key":"S2056469426102836_ref26","doi-asserted-by":"publisher","DOI":"10.1080\/13698575.2012.720965"},{"key":"S2056469426102836_ref10","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.116.182717"},{"key":"S2056469426102836_ref2","volume-title":"The Assessment of Clinical Risk in Mental Health Services","author":"Appleby","year":"2018"},{"key":"S2056469426102836_ref21","doi-asserted-by":"publisher","DOI":"10.1108\/MHRJ-01-2018-0001"},{"key":"S2056469426102836_ref36","doi-asserted-by":"publisher","DOI":"10.1192\/pb.25.6.217"},{"key":"S2056469426102836_ref5","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2008.027888"},{"key":"S2056469426102836_ref20","doi-asserted-by":"publisher","DOI":"10.1080\/14789949.2010.500740"},{"key":"S2056469426102836_ref27","doi-asserted-by":"publisher","DOI":"10.1080\/09638230701505848"},{"key":"S2056469426102836_ref30","doi-asserted-by":"publisher","DOI":"10.1080\/14999013.2024.2388091"},{"key":"S2056469426102836_ref17","volume-title":"Self-Harm: Assessment, Management and Preventing Recurrence","year":"2022"},{"key":"S2056469426102836_ref9","volume-title":"Assessing and Managing Risk in Mental Health Services","year":"2009"},{"key":"S2056469426102836_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.08.015"},{"key":"S2056469426102836_ref3","doi-asserted-by":"publisher","DOI":"10.1192\/bja.2022.67"},{"key":"S2056469426102836_ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-085673"},{"key":"S2056469426102836_ref16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0280789"},{"key":"S2056469426102836_ref19","doi-asserted-by":"publisher","DOI":"10.1108\/JMHTEP-09-2021-0113"}],"container-title":["BJPsych Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056469426102836","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:42:34Z","timestamp":1790923354000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056469426102836\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,2]]},"references-count":40,"alternative-id":["S2056469426102836"],"URL":"https:\/\/doi.org\/10.1192\/bjb.2026.10283","relation":{},"ISSN":["2056-4694","2056-4708"],"issn-type":[{"value":"2056-4694","type":"print"},{"value":"2056-4708","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,2]]},"assertion":[{"value":"\u00a9 Crown Copyright - NHS Greater Glasgow and Clyde, 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}