Patient perspectives of helpful risk management practices within mental health services. A mixed studies systematic review of primary research

Deering, Kris; Pawson, Chris; Summers, Neil and Williams, Jo (2019). Patient perspectives of helpful risk management practices within mental health services. A mixed studies systematic review of primary research. Journal of Psychiatric and Mental Health, 26(5-6) pp. 185–197.

DOI: https://doi.org/10.1111/jpm.12521

Abstract

Minimising the harm that patients pose to themselves and others, due to mental health difficulties, is a central component of risk management in psychiatry. However, risk management itself can cause patient harm, but despite this and the potentially informative value of lived experience, little is known about what patients want or expect from risk management.

Aim: To review research and explore what patients consider beneficial in risk management practice.

Method: A mixed‐studies systematic review utilising PRISMA guidelines, alongside a convergent qualitative design to categorise findings.

Results: 12 papers were identified, generating two categories of beneficial practices: interpersonal relationships and communication with clinicians; coupled with patient agency in their own risk management.

Discussion: Connectivity appears important. Particularly patients feeling involved, and their voices being heard in both the identification of risks and then shaping risk management practice. Moreover, this included involvement of friends, family, and peers to widen input and supportive networks beyond clinical relationships.

Implications for Practice: Risk management needs to be an accessible part of care, which is more inclusive of patient views and needs. The latter might also be aided by drawing on the patient's wider community in order to provide more effective support and risk management.

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