A novel CAMHS risk assessment system: clinicians’ views

Abstract

Purpose -The purpose of this paper is to record and analyse clinicians' views of the proposed FACE Child and Adolescent Risk Assessment Suite (CARAS). This is a novel risk assessment system comprising a set of screening questions and domain specific sub-schedules intended to be implemented in electronic format within a youth mental health setting. Design/methodology/approach -A qualitative approach was adopted with a series of focus groups conducted with three Child and Adolescent Mental Health Service (CAMHS) teams drawn from general and specialised services in a large NHS Trust in North-East England. A thematic analysis was used to explore the perceived clinical relevance, clarity and utility of the items that are contained within the FACE Child and Adolescent Risk Assessment Suite. Findings -Emerging themes highlighted that items such as criminality and fire-setting be added to the violence risk assessment schedule; a structured approach for risk of sexual harm be utilised; and an eating disorder risk assessment be included. Practical implications -Clinicians viewed the FACE Child and Adolescent Risk Assessment Suite as a structured and comprehensive risk management tool that also demonstrated potential clinical utility. CAMHS clinicians' views of the potential benefits of risk assessment schedules appear to be influenced by the perceived balance between comprehensiveness and ease and rapidity of administration. Further studies relating to validity and reliability are currently ongoing. Originality/value -This is the first qualitative exploration of a comprehensive and flexible approach to risk assessment in a youth mental health setting.

Innovations in Practice: Piloting a new child and adolescent risk assessment suite in the UK

“…Further research would be required to elicit the cause of nonconcordant ratings. The qualitative feedback supports earlier work (Daniel et al., ) indicating that the system, even in paper format, was acceptable, although there were some suggestions for improvement. Internal reliability consistency was generally high, as indexed by Cronbach's alphas.…”

“…After the initial development of the schedules, focus groups were held with CAMHS clinicians to provide in‐depth feedback on the draft FACE‐CARAS (Daniel, Weir, & Tiffin, ). This feedback suggested that the FACE‐CARAS was a generally well‐structured and clinically acceptable risk assessment suite (Daniel et al., ). The findings were subsequently fed back into the design of the system.…”

Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis

“…The FACE-CARAS toolkit has been developed to support practitioners in CAMHS in performing a structured risk assessment. 150 It covers multiple risk domains including violence, suicide, self-harm, experienced abuse and exploitation. The FACE-CARAS involves comprehensive risk assessment, including a risk scale -to produce a FACE Risk Profile and a clinical management plan (paper/electronic).…”

WARRN – a formulation-based risk assessment procedure for Child and Adolescent Mental Health Services (CAMHS): the view of clinicians

“…There is a strong association between attempting/completing suicide and poor mental health in this population (Shaffer et al, 1996) and so the assessment and management of risk of suicide is a major part of the work of CAMHS. Likewise, rates of violence are elevated in adolescents (Ellickson & McGuigan, 2000) and the assessment of violent behaviour forms a key part of the role of CAMHS (Firth, Spanswick, & Rutherford, 2009;Tiffin & Kaplan, 2004;Daniel, Weir, and Tiffin, 2013).…”