Understanding how mental health liaison practitioners make sense of their experiences with decisions related to life-threatening self-harm

Lawrence, Heather (2023) Understanding how mental health liaison practitioners make sense of their experiences with decisions related to life-threatening self-harm. Doctoral thesis, University of East Anglia.

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Abstract

Background
Suicide prevention continues to be at the forefront of public health initiatives. Research has shown that structured assessment tools have poor predictive ability and guidance suggests that suicide risk assessment should involve clinicians making judgments about pertinent risk factors and completing a needs-led assessment. This thesis aims to look at the role of clinical judgement in practice and the factors which may impact clinicians’ judgement. It also aims to explore clinician experience of making decisions regarding suicide risk assessment (SRA).

Methods
A systematic review synthesised the available evidence around the role of clinical judgement in suicide risk assessment. Databases were searched and included papers summarised. An empirical study was conducted exploring the in-depth experiences of clinicians making risk decisions. Eight liaison practitioners took part in interviews which were analysed using Interpretative Phenomenological Analysis.

Results
Nine studies met the inclusion criteria. Seven looked how clinician factors impacted risk rating and two looked at clinician experience of suicide risk assessment, with one of these papers also into current clinical practice of suicide risk assessment. There was large variability across the papers looking into clinician factors, however highlighted that clinician factors are likely to play a role in how a clinician rates risk. The empirical paper found six main themes were identified in the data: You can only do what you do can do; My team are my safety blanket; The only certainty is uncertainty; Putting my wellbeing first allows me to show up for others ; You can’t help but go back to what you’ve been through before; At the end of the day, you need to protect yourself

Conclusions
Clinician judgement is an under researched area, which is surprising due to the lack of predictive ability of structured assessment tools. This thesis highlights the impact clinician factors can have on risk ratings, the complexity of and variability of the risk decision process and the salient elements of a clinician’s experience. Although there is further research need, this thesis has shown the importance of recognising the clinician’s role in SRA

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	23 May 2024 06:28
Last Modified:	23 May 2024 06:28
URI:	https://ueaeprints.uea.ac.uk/id/eprint/95286
DOI:

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