Risk Assessment Reseach Report - Trinity College Dublin

Clinical Strategy and Programmes Division

Office of the Nursing & Midwifery Services Director

Risk Assessment and Safety Planning in Mental Health Nursing Services

An exploration of practices, policies and processes

ISBN No 978-1-906218-89-8

Office of the Nursing & Midwifery Services Director Clinical Strategy & Programmes Directorate Health Service Executive Dr Steenens' Hospital Dublin 8. Ireland. Telephone: +353 1 6352471 Email: nursing.servcies@hse.ie hse.ie

The report may be cited as follows: Higgins, A., Doyle, L., Downes, C., Nash, M., Morrissey, J., Brennan, M. & Costello, P. (2015) Risk assessment and safety planning within mental health nursing services: an exploration of practices, policies and processes. Dublin: Health Service Executive

The authors would like to thank to all the participants who took time to give important information to this study. We would also like to thank the Assistant Directors of Nursing in participating HSE regions as well as key gatekeepers within these regions for facilitating the study. Finally, thanks also to Jade Bailey, Ciara Leavy and Mike Keenan for their assistance with data entry and data collection and Ailish Gill for her assistance.

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Risk Assessment and Safety Planning in

Mental Health Nursing Services:

- An exploration of practices, policies and processes

Foreword

The Office of the Nursing & Midwifery Services Director (ONMSD) is delighted to present this research report into current practices, policies and processes around Risk Assessment and Safety Planning within mental health nursing in our Irish mental health services. This work was commissioned to provide an evidence base to inform recommendations for the profession on nursing policy, practice guidelines and education programmes in this area of Risk Assessment and Safety Planning and is the first of its kind for nursing internationally.

Contemporary international and national health policies all articulate the need for services to be driven by principles of quality and safety, with particular emphasis being placed on increased safety of service users, carers, families, staff and the community. Irish mental health policy is no different with an increasing emphasis being placed on the need for services to be driven by a quality and safety agenda. Within this agenda issues of risk have become increasingly dominant and this increased consciousness is equally true within mental health services. Policy and guidance documents emphasise the importance of partnership and collaboration between professionals, service users and families/carers when carrying out Risk Assessment and Safety Planning in mental health. Within mental health nursing, how risk is defined and classified needs to be evidence-based and responded to in a consistent way across all clinical settings and locations where care is delivered.

Over the past decade the clinical role and responsibilities of the nurse working in mental health services has developed significantly in order to provide responsive care. The ongoing developments and expansion of the scope of nursing practice at all levels including Specialist and Advanced practice in areas such as Liaison, Self-Harm, Suicide Crisis Assessment and Community Mental Health provides a complex and changing environment in which nurses' work. The ONMSD commissioned this report to support nurses working within their professional roles. This report will provide an evidence base to inform recommendations on nursing policy, practice guidelines and education programmes in this area of Risk Assessment and Safety Planning.

This report is the result of extensive consultation with nursing services nationally and provides evidence for the profession to inform the development of best practice principles and an elearning education programme on Risk Assessment and Safety Planning for all nurses working within Mental Health services nationally. We would like to thank the service users, nursing staff and Area Directors of Nursing who contributed to this groundbreaking work, and extend our appreciation to Professor Agnes Higgins and her team who carried out this work in the School of Nursing & Midwifery, Trinity College Dublin.

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Swords Business Campus, Balheary Road, Swords, Co. Dublin.

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