Violence risk assessment and management framework— mental health services
Annual report case study
The Office of the Chief Psychiatrist, Mental Health Alcohol and Other Drugs Branch, led the implementation of the Queensland Health response to the 2016 report, When mental healthcare meets risk: A Queensland sentinel events review into homicide and public sector mental health services.
A key project completed by the Chief Psychiatrist on March 2019 was the release of the Violence risk assessment and management framework—mental health services (Framework) (PDF 2773 kB).
The Framework is a guiding document for the identification, assessment and management of Queensland Health mental health service consumers who may pose a risk of violence towards others.
The Framework provides a structured three-tiered approach to risk assessment and management, whereby elevations in the level of risk posed are associated with a more comprehensive and specialised service response. Each tier of the Framework is supported by clinical documentation and training modules to build clinical competencies and capabilities.
The Framework, developed in consultation with mental health clinicians and consumer and carer representatives, was piloted across five HHSs between June 2018 and January 2019.
Evaluation of the pilot revealed that application of the Framework:
- improved the capability of clinicians and services to identify, assess, and develop risk management plans
- improved senior clinician involvement in the identification, assessment and management of consumers who pose a risk of violence, and particularly when levels of risk increased
- improved liaison with, and referrals to, specialist forensic mental health services to provide assessment and management support for consumers with complex needs and a significantly elevated risk of violence.
Statewide implementation of the Framework occurred between March and June 2018 and was supported by:
- an induction video providing an overview of the Framework and how it is applied. Access to this video will remain ongoing for refresher sessions and new staff induction
- delivery of a training package on violence risk assessment and management to senior clinicians and Consultant Psychiatrists to align with the response required at Tier 2 of the Framework
- local implementation site coordinators within HHSs. In addition to the provision of implementation resources/tool kits, the Mental Health Alcohol and Other Drugs Branch held monthly Statewide Site Coordinator Network meetings to provide further support and an opportunity to share lessons learnt.