Video Transcription

Hi everyone. Welcome to another psych student video.

Today we will be thinking about risk assessments. So, when conducting a risk assessment broadly you could get two types of situations that you might find yourself in. One is thinking about a person's risk in general terms. So, thinking about what factors might affect them. If they use drugs if they're in a particular age group, they might be at more risk of specific problems. At other times we are thinking about risk assessing after a specific incident has happened.

When we're thinking about general risk factors and the overall risk assessment for a person, we think about different categories of people who might be at risk. So, risks to themselves, any risks they might present to other people around them and then following on from that any risks they might have in terms of dependants. So, if they're caring for children for elderly relatives, and even animals sometimes we will take into account as well as if we are going to admit someone into hospital we don't want to be leaving their pets at home without anyone to feed them.

So, when we think about each of those risk factors there are specific questions, we might be asking ourselves. If we're thinking about risk to self, we think about any self-harm potential or any suicide or self-neglect factors. Are they keeping well fed? Do they keeping good hygiene? When we think about harm to others we are thinking more about if they've had any thoughts about wanting to harm anyone else, particularly if there's delusional content or command voices.

As I said when we think about dependants, we are thinking about anyone that they might be responsible for. So, it might be in these situations that we have to evolve specific people. Safeguarding, potentially police if there are real concerns about risk to other people, child protection and the RSPCA in terms of animal care issues.

Following on from that we think about more General risks again, what they're up to their day-to-day life, are they driving? For example, if you're looking at diagnosis such as dementia where they might need to inform the DVLA. Have they got access to anything at home that could potentially be a problem? Have they been able to stockpile medication? Maybe are they someone who has access to weapons? For example, if you're dealing with a person that's working out at a farm, they may have access to firearms, there are all sorts of other situations as well.

And then we think about any physical health issues. So potentially an older person who might be at risk of Falls or leaving the cooker on because they're not well cognitively.

And then we think about all of that within the context of that person. So, their past history is really important here. It might well be that they've been in trouble with the criminal justice system before. They may have served sentences particularly for violent and aggressive behaviour. We want to know about that when we're thinking about the risks. If they've been in the hospital before that might help us to assess for example, the extent of the risk to themselves if they been in ITU before. And then when we've seen them in the past, did they come to clinic before or come as a child. When did we first access them as a mental health service?

When we move on to thinking about a specific event, so, this might be an event of harm to other people or it might have been a risk of harm to self that has now come forward. So, potential suicide. So, we think about this in terms of before, during and after. Kind of in the same way we might think about somebody who has had a seizure.

So, planning. Before they did whatever the event was, did they write any letters to tell people what they were going to do? Did they change their will? Did they think about care for their dependents? Did they make any moves to avoid Discovery or to hide it if it was an offense? And did they have a specific date or time in mind or was this a really impulsive phenomenon?

During the event we think about where they were, when and how they did it. Whatever it was that they did. And what they felt at the time is very important to understand. When we think about the expectations that they had, what I mean by this is if for example, if they took an overdose of medication did they think that this would cause them harm, or do they think that it would kill them? Because whilst we might as professionals know how much would be a problem it potentially might be that they have a different understanding of what was going to happen. And then we think about how the issue was discovered and how they feel about things now. So, what their plans are for the future, do they feel guilty, do they regret any of the actions that they took? And, when we think about plans for the future we are also thinking about positive plans, so do they now think that actually this was something I regretted happening. Now, what I want to do is go and get my degree or any other plans or Ambitions.

We think about what support they have as well if they're at home, have they got people with them? Thinking more about support as a whole really does factor into our risk assessment and what we need to do next.

So, when we are doing risk assessments, we're thinking about what we can do to help. Do they need to come into Hospital? Can they go home? And have they got people at home with them? Do we need urgent outpatient appointments to give them more support in the more immediate term in the community? Can they access a specialist personality disorder service of some description? Lots of different areas will have access to different things. Then we think about the family and friends, their social structure, have they got people checking in on them? Is there a role for any medication in this case or do we need to be maybe thinking about writing to their GP and asking them to provide less medication at a time to help with limiting access to medication volumes? Potentially we might need Social Services involvement and supported accommodation or childrens services involvement for example CAMHS. So that's Child and Adolescent mental health care. There might need to be safeguards in place and Drug and Alcohol Services will help to reduce risks if that's a problem for them. And we're thinking about whether or not we need to evolve the mental health act or the mental capacity act in these situations.

Whatever the risk might be things change and we know our risk assessments are far from perfect. So, in any situation where you're talking to a person about risk, make sure they know who to contact if things get worse or if things change. You don't know what will happen to that person when they go back to their lives after they've met with you.

Thank you for watching this video. I hope this has been helpful. Please do like subscribe and share and check out our website if you enjoyed the video. Thanks.