Box 1Best practice in risk management (Department of Health, 2007a)



Best practice involves making decisions based on knowledge of the research evidence, knowledge of the individual service user and their social context, knowledge of the service user’s own experience, and clinical judgement.



Positive risk management as part of a carefully constructed plan is a required competence for all mental health practitioners.


Risk management should be conducted in a spirit of collaboration and based on a relationship between the service user and their carers that is as trusting as possible.


Risk management must be built on recognition of the service user’s strengths and should emphasise recovery.


Risk management requires an organisational strategy as well as efforts by the individual practitioner.

Basic ideas in risk management


Risk management involves developing flexible strategies aimed at preventing any negative event from occurring or, if this is not possible, minimising the harm caused.


Risk management should take into account that risk can be both general and specific, and that good management can reduce and prevent harm.


Knowledge and understanding of mental health legislation is an important component of risk management.


The risk management plan should include a summary of all risks identified, formulations of the situations in which identified risks may occur, and actions to be taken by practitioners and the service user in response to crisis.


Where suitable tools are available, risk management should be based on assessment using the structured clinical judgement approach.


Risk assessment is integral to deciding on the most appropriate level of risk management and the right kind of intervention for a service user.

Working with service users and carers


All staff involved in risk management must be capable of demonstrating sensitivity and competence in relation to diversity in race, faith, age, gender, disability and sexual orientation.


Risk management must always be based on awareness of the capacity for the service user’s risk level to change over time, and a recognition that each service user requires a consistent and individualised approach.

Individual practice and team working


Risk management plans should be developed by multidisciplinary and multi-agency teams operating in an open, democratic and transparent culture that embraces reflective practice.


All staff involved in risk management should receive relevant training, which should be updated at least every three years.


A risk management plan is only as good as the time and effort put into communicating its findings to others.


Cover of Antisocial Personality Disorder
Antisocial Personality Disorder: Treatment, Management and Prevention.
NICE Clinical Guidelines, No. 77.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2010.
Copyright © 2010, The British Psychological Society & The Royal College of Psychiatrists.

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