Mental Health Risk Assessment

General principles:

• Assessment should include a young person’s narrative about their own risk.
• Consent to risk assessment should be sought and an explanation of the risks and benefits given.
• Preparation is crucial and professionals should try to gather information from as many reliable sources as possible.
• Involving the young person and parents/carers (where appropriate) in drawing up the plan can enhance safety.
• Good relationships make any risk assessment more effective: consider who is the most suitable person to undertake this
• Always consult your line manager regarding any Mental Health Risk assessment you are undertaking with a young person and ensure their family are aware. 

Factors to consider:

History

• Previous violence, whether investigated, convicted or unknown to the criminal justice system
• Relationship of violence to mental state
• Lack of supportive relationships
• Poor concordance with treatment, discontinuation or disengagement
• Impulsivity
• Alcohol or substance use, and the effects of these
• Early exposure to violence or being part of a violent subculture
• Triggers or changes in behaviour or mental state that have occurred prior to previous violence or relapse
• Are risk factors stable or have any changed recently?
• Is anything likely to occur that will change the risk?
• Evidence of recent stressors, losses or threat of loss
• Factors that have stopped the person acting violently in the past
• Are the family/carers at risk? History of domestic violence
• Relationship of violence to personality factors
• Lack of empathy

Environment

• Consider protective factors or loss of protective factors
• Relational security
• Access to medications, violent means or opportunities
• Involvement in radicalisation 

Mental state

• Voicing emotions related to violence to self or others or exhibiting emotional arousal (e.g. irritability, anger, hostility, suspiciousness, excitement, enjoyment, notable lack of emotion, cruelty or incongruity)
• Specific threats or ideas of retaliation towards a specific individual
• Grievance thinking
• Thoughts linking violence and suicide 
• Thoughts of self- harm
• Evolving symptoms and unpredictability
• Signs of psychopathy
• Restricted insight and capacity
• Young person’s own narrative and view of their risks to self or others
• What does the person think they are capable of?

When taking a young person known to be self-harming on a residential trip:

• Discuss with them first how they will emotionally manage the change of being away from home
• Have an open and honest conversation as to whether they intend to bring objects to harm, discuss the risks to self and the wider group
• Have an action plan in place of they feel at risk of harm to themselves
• Have a specific individual staff member responsible for liasing with the young person and informing the staff team of any changes in mood, safety or incidents
• Discuss with the parents/carers an action plan for ensuring safety – it may be considered a ‘safer’ option to have parents/carers staying nearby 

Information from other sources:

Has everyone with relevant information been consulted? This includes parents, carers, staff team , pastoral staff and most importantly, the young person.

Conclusion:

Any decisions regarding the implementation of this risk assessment should be communicated clearly both verbally and in written form to the young person and an action plan put into place that is appropriate to the emotional, mental and cognitive needs of the individual.