Self-Harm and Violence

Richard Whittington is Professor of Mental Health in the School of Health Sciences at the University of Liverpool and an Honorary Research Fellow at Mersey Care NHS Trust. He has a PhD from the Institute of Psychiatry in London, and is a researcher and forensic psychologist with a particular research interest in the issues of violence, self-harm and mental health. Caroline Logan is a Consultant Forensic Clinical Psychologist in Greater Manchester West Mental Health NHS Foundation Trust and an Honorary Research Fellow at the University of Manchester. She has a DPhil from the University of Oxford and is both practitioner and researcher, focusing on violence and self-harm, personality disorder and risk.

Contributors xvii

Foreword xix

Preface vii

1 Introduction 1
Richard Whittington and Caroline Logan

Part I Experience 9

2 Service Users: Experiences of Risk and Risk Management 11
Kay Sheldon

3 Carers: Experiences of Risk and Risk Management 35
Sally Luxton

Part II Evidence 53

4 Understanding and Managing Self-Harm in Mental Health Services 55
Maria Leitner and Wally Barr

5 Understanding and Managing Violence in Mental Health Services 79
Richard Whittington, James McGuire, Tilman Steinert and Beverley Quinn

6 Suicide and Homicide by People with Mental Illness: A National Overview 97
Kirsten Windfuhr and Nicola Swinson

7 Evidence and Principles for Service User Involvement in Risk Management 119
Helen Gilburt

Part III Practice 143

8 Guidelines and Standards for Managing Risk in Mental Health Services 145
Caroline Logan, Norbert Nedopil and Thomas Wolf

9 Organizations, Corporate Governance and Risk Management 163
Ben Thomas

10 Formulation in Clinical Risk Assessment and Management 187
Caroline Logan, Rajan Nathan and Andrew Brown

11 Evidence and Principles for Positive Risk Management 205
Paul Clifford

12 Encouraging Positive Risk Management: Supporting Decisions by People with Learning Disabilities Using a Human Rights-Based Approach 215
Richard Whitehead, Ged Carney and Beth Greenhill

Part IV Implementation 237

13 Case Study 1: A Four-Step Model of Implementation 239
Geraldine Strathdee, Phil Garnham, Jane Moore and Devendra Hansjee

14 Case Study 2: Narrowing the Gap between Policy and Practice 251
Kate Hunt

15 Case Study 3: Learning from Experience – Using Clinical Risk Data to Influence and Shape Clinical Services 259
Louise Fountain and Patrick McKee

16 Case Study 4: From Ticking Boxes to Effective Risk Management 267
Lorna Jellicoe-Jones, Mark Love, Roy Butterworth and Claire Riding

17 Conclusions 279
Caroline Logan and Richard Whittington Glossary 287

Index 297