The Scottish High Risk Mental Health Youth Project (IVY)– Key Findings and Messages for Practice Leanne Gregory, Principal Clinical Psychologist, IVY Heather Irving, Social Worker CYCJ/IVY Nota Scotland Conference 29 th April 2014
Dec 30, 2015
The Scottish High Risk Mental HealthYouth Project (IVY)– Key Findings
andMessages for Practice
Leanne Gregory, Principal Clinical Psychologist, IVYHeather Irving, Social Worker CYCJ/IVY
Nota Scotland Conference29th April 2014
Framework for Risk Assessment Management and Evaluation (FRAME)
http://www.rmascotland.gov.uk/standardsandguidelines/
Risk Formulation
Formulation is the summation and integration of the knowledge that is acquired by the assessment process (which may involve a number of different procedures). This will draw on psychological theory and data to provide a framework for describing a problem, how it developed and is being maintained”
Division of Clinical Psychology 2001; cited Johnstone & Dallos (2006)
Risk Formulation
Formulation is not a new or novel concept in general terms; it is used in each of the main models of psychotherapy – behavioural, cognitive-behavioural, psychodynamic, systemic and integrative approaches - these are theoretically guided or model specific forms of formulation.
Risk Formulation
No single theory or model of violence exists
therefore
A pragmatically guided formulation has more utility in risk assessment
4 P’s Approach
• predisposing (i.e., factors in the individual’s past that may increase his proclivity or vulnerability to violence)
• precipitating (i.e., events or circumstances that may trigger the behaviour or disinhibit usual behavioural controls); (motivators, disinhibitors)
• perpetuating (i.e., factors that cause the risk to remain) (impeders, unresolved vulnerabilities)
• protective factors (i.e., aspects of the offender’s functioning or circumstances that moderate the risk)
4
11
22
2
1
15
2
13
LOCALITY/BOARD Number
East Dumbartonshire 1
East Lothian 1
Dumfries and Galloway 4
Falkirk 2
Fife 2
Glasgow 2
Highlands 1
Inverclyde 1
Lanarkshire 5
Moray 2
North Ayrshire 1
Renfrewshire 3
Map of Scotland provided courtesy of FreeVectorMaps.com
Diagnosed or Suspected Difficulty Number
Anger 7
Anxiety 1
Autism Spectrum Disorder 6
Attachment Disorder 5
Attention Deficit Hyperactivity Disorder 6
Communication Disorder 1
Complex Post Traumatic Stress 6
Deliberate Self-Harm 7
Dissociation 2
Eating Difficulties 2
Emotional Dysregulation 6
Learning Disability 2
Low Mood 2
Oppositional Defiant/Conduct Disorder 2
Psychosis 2
Sleep Difficulties 2
Substance Misuse Difficulties (Alcohol/Drugs) 7
Suicidal Ideation/Action 6
Unusual perceptual experiences 3
MEAN = 4.4
PRIMARY RISK
N = 17Nature of Risk n =
Primary Risk
Fire-setting 1
Interpersonal Violence
10
Self-harm/Suicidality 3
Sexual offences (contact)
5
Sexual offences (non-contact)
1
Victimisation 1
Violent Extremism 1
Interpersonal Violence
Suicide /DSH
Firesetting
Sexual offences
non-contact
Violent Extremism
Victimisation
Sexual offence - contact
Nature of Risk n = Secondary
Risk
Fire-setting 1Interpersonal Violence
3
Self-harm/Suicidality
3
Sexual offences (contact)
0
Sexual offences (non-contact)
1
Victimisation 5Violent Extremism
0
SECONDARY RISK
Victimisation
Suicide /DSH
Firesetting
Sexual offences
non-contact
Interpersonal violence
Level 2
10 offered 9 accepted
Risk Assessment Learning Disability
Personality
Mental Health Diagnostic Review