ABSTRACT
In this chapter we address an issue of increasing importance to clinicians, the assessment and management of risk. Risk assessment and management is a core task for mental health professionals, particularly those working in forensic settings (Blumenthal and Lavender, 2000; DH, 2007). This is even more the case with the move in the United Kingdom towards mental health professionals other than psychiatrists working as Responsible Clinicians with a much broader range of staff now being appointed as Approved Mental Health Professionals (Mental Health Act, 2007). Risk assessment outcomes inform decisions about whether someone is ready for discharge from hospital, their level of community leave, the need for initial detainment as an inpatient under the Mental Health Act (2007), the need for Compulsory Treatment Orders (CTOs) and more broadly the level of supervision and allocation of resources required for the individual concerned. As noted in Chapter 1, individuals with psychosis are at a higher risk than the general population of committing violence to others and suicide (Swanson et al., 1990; Powell et al., 2000; Monahan et al., 2001; Daffern et al., 2007; Pompili et al., 2007). People with psychosis may, however, be at risk in a number of other ways, which have been less rigorously studied: risk of deliberate self-harm; risk of damage to property or arson; vulnerability to self-neglect or to exploitation by others; neglect of dependants; risk of being the victim of violence due to bizarre or unusual behaviours; and risk of accidental injury due to poor attention/concentration or distraction by psychotic phenomena.
