Q/A Session Oct 2024: Regarding risk status, how do we determine the comparison group?
Question: Regarding risk status, how do we determine the comparison group? The same patient could be at increased risk when compared to other members in their unit/workplace but at decreased risk compared to other members presenting in crisis to the health centre. Two clinicians could choose two completely different comparison groups, which then alters the member's assessed 'risk status'.
Answer: It's common and often beneficial for clinicians to choose different comparison groups when describing risk status. The purpose of the assessment is to plan and describe risk status relative to different care settings that can inform the needed plans and supports.
For example: "This person's risk is higher than others currently being supported by the service I'm in, but similar to people in this other setting or with this additional support."
The "why" behind the assessment is more important than the categorisation itself. When communicating risk, it's crucial to explain the reasoning.
For example, if you are doing a handover, you might say, “This person's suicide attempt seemed to come out of nowhere. It was more impulsive, and the attempt that he made previously was nearly lethal because he was in a place where nobody would have found him except by accident. He also has several stressors that are higher than I've probably ever seen, and I've been seeing him withdraw and come less. So his risk status was much higher than most members I’ve seen for risk assessment, even relative to those who have had a recent suicide attempt”.
This communicates a high level of concern about the person relative to others seen in the setting. When doing a handover, this helps the person understand the concerns and that, therefore, the plans and responses developed to support the person would need to be robust, even more so than those they typically see.
It can be helpful to discuss with the unit or workplace what the comparison group and parameters should be.
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