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The purpose of this mixed methods rapid study was to identify the barriers and facilitators to implement relational and environmental risk management approaches to manage suicidality in inpatient services.

To achieve this within a short timeframe, a rapid review approach was chosen. Both research (qualitative and quantitative studies) and non-research material (policies, guidance and reports) were retrieved. The review was conducted across five databases: MEDLINE, EMBASE, EMCARE, PsycINFO and CINAHL for English language citations within the last ten years (2009 –2019).

A total of 17 primary research papers and a further 73 reviews and grey literature were included. There was evidence that the removal of anti-ligature equipment, by which regular checks of the environment to identify and remove ligature points and increased levels of observation are carried out well, reduces suicide in hospital.

There is a gap in research investigating “engagement activities” eliciting exactly what they are and determining how they might be effective. There is a need for new innovative ways for managing risk of suicide in hospitals that bring together meaningful engagement and maintaining safety.

Keeping people safe during an inpatient stay in a mental health service is a core function of mental health practitioners. This paper brings together what is already known about risk management and highlights areas for further investigation.

Suicide prevention is a priority issue in HM Prison Service of England and Wales. Past training in this area has concentrated on the completion of paperwork over direct interactions with suicidal people. HM Prison Service commissioned STORM, a training scheme focusing on interviewing skills and the identification of risk factors, successfully used in community health settings, piloted it in five prisons and retained it as part of its compulsory training for prison assessors of suicide risk. Although from spring 2007 STORM will no longer be compulsory, its impact has been shown in plans for future development of training.

The most significant sources and environmental pathways of manmade radionuclides have recently been examined by the RADPATH (Biochemical Pathways of Artificial Radionuclides) project, which was initiated under the auspices of the SCOPE (Scientific Committee on Problems of the Environment) unit. The accident at the Chernobyl nuclear power plant in 1986, with its associated radionuclide release, has provided an unexpected data source concerning movement of materials within various environmental compartments. Outlines some of the findings of the SCOPE‐RADPATH project, a particular focus of which was the Chernobyl accident, with reference to the atmospheric, terrestrial, aquatic and urban environments.

People with dual diagnosis have complex needs and vulnerabilities that may lead to incarceration in prisons. Mental health and substance use services in prisons should have the capabilities to address their needs while incarcerated and facilitate the transfer of care to community services on release. In order to develop these capabilities, a training programme is required.A pilot training programme for dual diagnosis was developed and piloted in five London prisons. The training was based on a training needs assessment of prison staff and consultation with service users. It was delivered in two forms: a five‐day classroom based course, and a ‘blended learning’ method that comprised a manual and three sessions of supervision. The course was evaluated by a brief questionnaire that included items on attitudes, self‐efficacy and knowledge about working with dual diagnosis.The evaluation of the training revealed that all workers, no matter what method of training they received increased their perception of their skills (self‐efficacy) and increased their attitudes. Knowledge remained the same (although the scores pre‐training were high). There was no difference between the two types of training when mean scores were compared at post‐training. There was also no difference between the mental health and substance workers regarding their mean scores at follow‐up, apart from knowledge.The conclusion is that the training pilot was evaluated positively and did indicate that it has some effect on attitudes and self‐efficacy. More rigorous evaluation of the impact of the training is required, using a robust methodology and assessing the impact on clinical skills and service user outcomes.

There is a dissonance between the purposes and services of the justice system compared to the needs of suicidal people or those with mental health problems. Correctional authorities are faced with sometimes difficult responsibilities when they have to incarcerate those who fall through the gaps in the social safety net. Correctional Service Canada’s (CSC) mandate is to carry out the sentences of two or more years imposed by the Court; consequently that federal authority may have more time and means than its provincial counterparts receive for inmates on remand or serving shorter sentences. CSC developed strategies for inmates with mental health problems and, specifically, an exhaustive suicide prevention program. The implementation of all the components of the mental health strategy is not completed but it is based on good planning. With respect to suicide prevention activities, these are mainly based on screening the most vulnerable inmates at the time of intake, but they cover a larger spectrum.

Points out that traditional conceptions of accounting history and its achievements are being challenged by new accounting historians who are informed by radical philosophies and approaches to history. Suggests that this is a belated reflection of movements within the wider discipline of history which can be traced to the annalists in the 1930s and more recently to the influence of postmodernism. Observes that at issue between the traditional and new history are the importance of facts and the pursuit of truth by traditional historians, noting that new accounting historians have decried the reactionary effects of traditional history, which they propose to overcome by substituting accounting as an interested discourse for accounting as a neutral, socially sterile technique. Explains that, as the conventional form of historical writing, the narrative form also has been disparaged. Concludes by arguing that accounting historians should be tolerant of different approaches to accounting history.

The current risk management system for community mental health patients in England is based around the Care Programme Approach (CPA). This system is not responsive to changes in risk for community patients. This paper aims to introduce a practical system to manage risk that has been developed for an Early Intervention Service in East London on the basis of need.

Coding of red, amber and green is associated with specific criteria agreed by all disciplines in the team. The change of a code leads to a rapid change in risk level and management. An agreed clinical and non‐clinical action plan leads to a whole team response. The limitation of use is dependent on the size of the case load and the number of clinical staff attending a daily clinical briefing.

Zoning according to the traffic lights system could complement the CPA system and support a clinical governance structure utilising a whole team response.

The risk management system described has not been tested empirically. Currently it has been used in early intervention mental health teams but will need to be adapted for other teams with bigger case loads.

This practical risk management system is aligned with the statuary CPA requirements. A dynamic and flexible management of risk is central to early intervention in psychosis teams but the risk management system described can suit any community mental health team and fits well with the distributed responsibility model of functionalised teams according to new ways of working.

The purpose of this paper is to report on the content of local policies on engagement and observation written by National Health Service (NHS) organisations in England and Wales.

Engagement and observation policies were obtained from all (n = 61) NHS mental health trusts in England and health boards in Wales via a Freedom of Information Act 2000 request. Data were analysed using content analysis.

All organisations had a specific policy referring to either “observation and engagement” or “observation”. The policies varied considerably in quality, length, breadth and depth of the information provided. Significant variations existed in the terminology used to describe the different types of enhanced observation. Inconsistencies were also noted between organisations regarding: which members of the clinical team could initiate, increase, decrease and terminate observation; who could undertake the intervention (for example students); and the reasons for using it. Finally, despite rhetoric to the contrary, the emphasis of policies was on observation and not engagement.

This research has demonstrated the value of examining local policies for identifying inconsistencies in guidance given to practitioners on the implementation of engagement and observation. Further research should be undertaken to explore the impact of local policies on practice.

Local policies remain variable in content and quality and do not reflect contemporary research. There is a need to produce evidence-based national standards that organisations are required to comply with.

To the best of the author’s knowledge, this is the first research in 20 years examining the local policy framework for the implementation of engagement and observation.

Suicide and self‐harm are major public health issues. This study aimed to assess how local and national data could be used more effectively in local suicide and self‐harm prevention strategies. Twelve semistructured interviews were carried out with a purposive sample of suicide prevention leads in one strategic health authority area and other key local and regional informants. Although suicide prevention work is supported by data, problems were identified with current processes and data and information availability. Local, regional and national health agencies all have a role in ensuring information is used in the best possible way to reduce self‐harm and suicide.