A novel CAMHS risk assessment system: clinicians’ views
| DOI | https://doi.org/10.1108/JFP-09-2012-0011 |
| Date | 02 August 2013 |
| Published date | 02 August 2013 |
| Pages | 182-191 |
| Author | Matthew R. Daniel,Steve Weir,Paul A. Tiffin |
| Subject Matter | Health & social care,Public policy & environmental management,Sociology |
A novel CAMHS risk assessment system:
clinicians’ views
Matthew R. Daniel, Steve Weir and Paul A. Tiffin
Matthew R. Daniel is a
Research Associate at the
School for Medicine, Pharmacy
and Health, Durham University,
Stockton-on-Tees, UK.
Steve Weir is a Project
Manager at FACE Recording
and Measurement Systems,
Nottingham, UK.
Paul A. Tiffin is a Clinical Senior
Lecturer at the School for
Medicine, Pharmacy and
Health, Durham University,
Stockton-on-Tees, UK.
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 Trustin 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 rapidityof 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.
Keywords Risk assessment, Children, Adolescents, Validity, FACE
Paper type Research paper
Risk assessment with young people
The assessment and management of risk is a key part of the role of clinicians working in Child
and Adolescent Mental Health Services (CAMHS). Despite this, there is a lack of guidelines
and research literature to support evidence-based practice in this area. Indeed, reliable and
valid schedules and instruments to improve the quality and consistency of risk assessment
in CAMHS are urgently required (Borum and Verhaagen, 2006; Tiffin and Richardson, 2006;
Tiffin and Nadkarni, 2010; Schmidt et al., 2011).
A number of risk assessments for young people already exist (Augimeri et al., 2001; Borum
et al., 2003; Forth et al., 2003; Levene et al., 2001). For some of these risk assessments there is
sufficient evidence to suggest that they are valid and clinically reliable tools (Tiffin and Nadkarni,
2010). For example, total scores on the structured assessment of violence risk in youth
(SAVRY – Borum et al., 2003) have been shown to have some ability to predict recidivist
violence; one study of Scandinavian young people in the secure estate reported that high vs low
scorerson the SAVRY had an odds ratio(OR) of 27.85 of recidivistviolence at six-month follow-up
(Gammelga
˚rd et al., 2008). For moderate vs low scorers the OR was 3.83 for recurrence of
violence. However, most of these tools, as in the case of the SAVRY, only assess specific areas
This partnership received financial
support from the Knowledge
Transfer Partnerships Programme
(KTP). KTP aims to help businesses
to improve their competitiveness
and productivity through the better
use of knowledge, technology and
skills that reside within the UK
knowledge base. KTP is funded by
the Technology Strategy Board
along with the other government
funding organisations. The partners
involved in this project: Durham
University; Tees, Esk and Wear
Valleys NHS Trust;FACE Recording
and Measurement Systems. Paul
A. Tiffin is supported in his research
by a HEFCE Clinical Senior Lecturer
Fellowship. The authors would also
wish to acknowledge the support
and input of Dr Dasha Nicholls,
Chair of the Royal College of
Psychiatrists Junior MARSIPAN
working group, from whom they
sought and obtained permission to
use the MARSIPAN guidance to
inform the development of the draft
FEDS schedule.
PAGE 182
j
JOURNAL OF FORENSIC PRACTICE
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VOL. 15 NO. 3 2013, pp. 182-191, CEmerald Group Publishing Limited, ISSN 2050-8794 DOI 10.1108/JFP-09-2012-0011
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