Risk assessment in mental health: staff attitudes and an estimate of time cost

Background : Risk assessment is a routine part of mental health services, with professionals being required to complete a risk assessment proforma (RAP) for every patient under their care. Aims : This study was designed to investigate staff attitudes to, and beliefs about, the completion of risk assessment paperwork. Method : We surveyed 300 professionals across one county to examine: (i) the amount of time taken to complete RAPs; (ii) attitudes towards completing such paperwork; and (iii) beliefs about the quality and usefulness of the information recorded. Results : We found considerable variation in the amount of time taken to complete RAPs. The median time was 18 minutes with doctors spending significantly less time than nurses. More favourable attitudes towards RAPs were seen in nurses than in doctors, in spite of the increased time spent completing them. Moreover, nurses also held more positive views about the value and benefit of the information recorded in RAPs. Conclusions : The findings suggest that RAP completion may account for a significant proportion of staff time. Inter-professional differences in belief and attitude were prominent and this should be an important consideration in the evolution of risk assessment procedures.