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This paper aims to describe the issues in risk assessment and management of autism spectrum disorders in secure hospital settings with reference to best practice guidance.

The author undertook a review of the current literature on risk management in autism spectrum disorders and has drawn on clinical experience to highlight key issues.

Risk assessment and management needs to be tailored to individuals. Characteristics of offences differ compared to other mental disorders. Underlying factors for offending differ from other mental disorders and may be misinterpreted.

Risk assessment in autism spectrum disorders should take into account individual characteristics and be informed by specialist assessments. Management should be based on a formulation informed by assessments and by recognising individual characteristics.

The paper highlights important issues in risk assessment and management of patients with autism spectrum disorders particularly in secure hospital settings.

The purpose of this paper is to examine the extent to which risk is addressed in the risk management planning process of those convicted of sexual offending.

Data were collected from a risk assessment and management system called the Offender Assessment System (OASys), used by the National Offender Management Service, in England and Wales. The records of 216 clients were accessed and each risk management plan analysed. The study aimed to understand if first, general and sexual risk factors identified by assessors were recorded and detailed in subsequent plans; second, if specialist sexual offending risk assessment tools were used to inform risk management strategies; and third, if both a balance of control and support mechanisms were in place to tackle identified risk and needs of clients.

Inconsistencies were found in relation to practitioners transposing risks identified, into the subsequent risk management plans. Strategies were therefore deemed, inadequate as there was a significant omission of the use of specialist sexual risk assessment tools to inform and ensure risk assessment to be robust. In addition risk management plans were often overbearing in nature, as assessors tended to utilise control strategies to assist the reintegration process, in contrast to a combination of both control and support.

This sample was taken from only one probation trust in England and Wales. The findings might therefore be unique to this organisation rather than be representative of national practice. This study should therefore, be replicated in a number of other probation areas. In addition, it is important to note that this study only reviewed one electronic tool used by practitioners. Therefore, while it might appear for example that the RM2000 tool was not routinely completed; this cannot be assumed as practitioners might have adopted local custom and practice, recording RM2000 scores elsewhere.

These findings highlight the need for some understanding as to why there is a lack of consistency throughout the risk management planning process. Practitioners should receive ongoing risk management training, development and supportive supervision. In particular, practitioners require supervision that supports and develops their skills when applying RM2000 classifications to their clients’ risk management plans. Likewise initiatives which develop practitioner’s awareness and application of strengths based approaches such as the Good Lives Model should be encouraged. These will help practitioners develop plans that address both the risks while supporting their development of the strengths a client presents.

To the authors’ knowledge, this is the first study of its kind, which examines the risk management plans of those convicted of sexual offending, completed by practitioners in England and Wales using the OASys tool.

The purpose of this study is to improve compliance with clinical risk procedures across a United Kingdom based mental health trust.

A cross‐sectional audit was carried out in April 2010. In total, 70 Risk Assessment Proformas (RAPS) were measured against an agreed “gold‐standard”. The standards were a combination of Department of Health recommendations as well as the current Hertfordshire Partnership NHS Foundation Trust (HPFT) policy on clinical risk assessment.

Only 53 (out of a possible 70) RAPS were completed. The acute and community psychiatric service stream samples on the whole provided more information within their RAPS than other parts of the service. There were overall low levels of documentation regarding service user and carer involvement.

To strengthen the clinical management of risk (and thus reduce harm) in mental health settings a systematic approach to risk assessment should be present. This involves clinicians working in partnership with both service users and carers. Based on the results, more needs to be done to actively involve carers and the service user in formulating the risk management plan. Not only will this promote positive risk management within the organization it will also enable individual “recovery”.

By auditing the organizational processes that underpin the management of risk, deficiencies in clinical care can be identified. Mental Health Trusts can promote positive risk management within their organization by engaging service users and their carers in managing risk.

Police play an essential role in reducing harms associated with family violence by identifying people at increased risk of physical or mental health-related harm and linking them with support services. Yet police are often poorly trained and resourced to conduct the kind of assessments necessary to identify family violence cases presenting with increased risk. The paper aims to discuss this issue.

This paper describes a multi-project collaboration between law enforcement, forensic mental health, and academia that has over three years worked to improve risk assessment and management of family violence by police in Victoria, Australia.

Evaluation of existing risk assessment instruments used by the state-wide police force showed they were ineffective in predicting future police reports of family violence (AUC=0.54-0.56). However, the addition of forensic psychology expertise to specialist family violence teams increased the number of risk management strategies implemented by police, and suggested that the Brief Spousal Assault Form for the Evaluation of Risk assessment instrument may be appropriate for use by Australian police (AUC=0.63).

The practical implications of this study are as follows: police risk assessment procedures should be subject to independent evaluation to determine whether they are performing as intended; multidisciplinary collaboration within police units can improve police practice; drawing on expertise from agencies external to police offers a way to improve evidence-based policing, and structured professional judgement risk assessment can be used in policing contexts with appropriate training and support.

The paper describes an innovative collaboration between police, mental health, and academia that is leading to improved police practices in responding to family violence. It includes data from the first evaluation of an Australian risk assessment instrument for family violence, and describes methods of improving police systems for responding to family violence.

Purchasing organizations are exposed to risk in their interactions with suppliers, whether it is recognized and managed, addressed in a cursory manner, or altogether ignored. In order to understand the supply risk that exists, purchasing organizations can proactively assess the probability and impact of supply risk in advance, or reactively discover risk after a detrimental event occurs. The purpose of this study is to explore, analyze, and derive common themes on supply risk assessment techniques. Findings from this research indicate that purchasing organizations can assess supply risk with techniques that focus on addressing supplier quality issues, improving supplier processes, and reducing the likelihood of supply disruptions. From an agency theory perspective, these risk assessment techniques facilitate the obtaining of information by purchasing organizations to verify supplier behaviors, promoting goal congruence between buying and selling firms, and reducing outcome uncertainty associated with inbound supply.

The purpose of this paper is to examine empirical, epistemological and conceptual challenges and clinical narratives in the application of risk assessment and management in mental health.

The authors used a narrative review of empirical, conceptual and clinical literature.

The worldwide prevalence of violence in mental health settings remains high. Risk assessment and management approaches, while well intentioned as an attempt to reduce harm and increase people’s safety, have negligible effect on both. They are invariably individual centric, ignore wider environmental, societal and behavioural influences that foment violence and have a stigmatising effect on people using mental health services. They also reinforce the myth that people who are mentally unwell threaten society and that through current risk assessment and management approaches, we can minimise this threat.

There is a need to reconsider the study and application of violence risk assessment in mental health.

The practice of risk assessment and management in mental health is marred by an overuse of risk assessment measures that are limited in their predictive efficacy. As a result, they have little value in preventing, reducing and/or managing harm. The language of risk punishes and stigmatises service users and reinforces the image of menace. An alternative language of safety may nourish and protect. A collaborative approach to safety assessment based upon recovery-focussed principles and practices may fuse professionals and service users’ horizons. Combining service users’ self-perception, professionals’ sound clinical judgement, assisted by electronically derived risk algorithms and followed by evidence-based risk management interventions, may lessen the threat to service users, reduce harm and transform the practice of violence risk assessment and management.

Risk appraisals discriminate against the small number of people who have a mental illness and are risky, an example of preventive detention that is ethically questionable. On the basis of the limitations of the predictive efficacy of actuarial measures, it is ethically dubious to subject people to interventions with limited benefits. Risk assessment processes tend to reinforce stigma by classifying individuals as risky, sanctioning society’s prejudices and fear through scientific authority.

The increasing focus on risk assessment and management to tackle violence in mental health is fraught with empirical, conceptual and practical concerns; the authors have suggested ways in which these concerns can be addressed without compromising people’s safety.

This paper reviews the current issues in risk assessment and risk management facing practitioners, and draws upon current literature to argue for an holistic approach to assessment. The demands of risk management in a climate of risk avoidance are briefly reviewed, and key principles for effective risk management offered.

Risk assessment is a fundamental part of clinical practice in mental health and learning disability services in the UK. Most services use a tool or framework to structure their clinical judgments, but there does not appear to be a consensus on which risk assessment tool should be used. This paper aims to describe the development, implementation and evaluation of an evidence-based formulation informed risk management (FIRM) framework in mental health and LD services.

The development of FIRM and evaluation was based on the model for improvement, with an emphasis on co-production broken down into three distinct yet interdependent phases of co-production: co-design, co-create and co-deliver. Following the implementation of the FIRM framework, a post-implementation survey was distributed to a sample of clinical staff to capture experiences in the first three months post-implementation.

The three co-production stages were pivotal for successful implementation in clinical practice. The key ingredients for success seemed to be acknowledging human factors and varied responses to change, communication, engagement and involvement of stakeholders. Early evaluation post-implementation demonstrated the benefits in terms of confidence in use, formulation of risk, risk management and communication. Further quality improvement initiatives are underway to evaluate impact up to 12 months post-implementation and to improve the quality of FIRM in practice. Future research is planned to look at enhancing personalised risk assessment and management.

This paper describes and demonstrates the value of co-production with clinicians and stakeholders in service development. The FIRM has improved the clinical practice of risk assessment, formulation and management and use of digital technology.

The purpose of this paper is to develop a model for upstream supply chain risk management linking risk identification, risk assessment and risk mitigation to risk performance and validate the model empirically. The effect of a continuous improvement process on identification, assessment, and mitigation is also included in the model.

A literature review is undertaken to derive the hypotheses and operationalize the included constructs. The paper then tests the path analytical model using partial least squares analyses on survey data from 162 large and mid‐sized manufacturing companies located in Germany.

All items load high on their respective constructs and the data provides robust support to all hypothesized relationships. Superior risk identification supports the subsequent risk assessment and this in turn leads to better risk mitigation. The model explains 46 percent of the variance observed in risk performance.

This study empirically validates the sequential effect of the three risk management steps on risk performance as well as the influence of continuous improvement activities. Limitations of this study can be seen in the use of perceptional data from single informants and the focus on manufacturing firms in a single country.

The detailed operationalization of the constructs sheds further light on the problem of measuring risk management efforts. Clear evidence of the performance effect of risk management provides managers with a business case to invest in such initiatives.

This is one of the first large‐scale, empirical studies on the process dimensions of upstream supply chain risk management.

Self-harm is a cause of concern for health-care professionals. The Short-Term Assessment of Risk and Treatability (START) is a short-term assessment instrument used to rate the likelihood of risk behaviours, including self-harm. As result of the assessment, interventions that are implemented to reduce the risk of self-harm may reduce the strength of the predictive validity of a risk assessment tool. The aim of this study was explore the impact of risk management interventions on the capacity of START to predict self-harm. It was predicted that the interventions would weaken the ability of START to predict self-harm in patients who received the intervention.

Secondary analysis of routinely collected data in a large sample of women in an inpatient secure care setting. Demographic and clinical information, self-harm episodes, safety management interventions and START assessments were extracted and used to build an anonymous database.

START significantly predicted self-harm in those with and without the safety management intervention. However, the strength of the predictive validity was smaller in those who received the intervention compared to those without.

The results suggest that the implementation of safety management interventions needs to be taken into account when assessing future risk of self-harm.

To the best of the authors’ knowledge, this is the first study to explore the impact of safety management interventions on the predictive validity of START in a large sample of women.