The Health Services Safety Investigations Body (HSSIB) have released their interim report 'Creating conditions for learning from deaths and near misses in inpatient and community mental health services: Assessment of suicide risk and safety planning'.
The report outlines patient safety concerns relating to the continued use of risk stratification, which studies have found to be ineffective;
“The use of risk assessment tools that provide a high, medium, or low risk score is no longer acceptable but continue to be used contrary to national guidelines for self-harm assessment."
Creating conditions for learning from deaths and near misses in inpatient and community mental health services: Assessment of suicide risk and safety planning
Some mental healthcare providers have begun work to support the changes in culture and practice that are needed to move towards more person-centred approaches to safety planning for people with mental health needs.
HSSIB observed organisations can improve patient safety by taking a person-centred approach to biopsychosocial assessments, involving 'digital experts' and involving patients, families and carers about the safety and wellbeing of people who have self harmed and/or are expressing suicidal thoughts.
Read the full report
Related Event: Implementing the Patient Safety Incident Response Framework (PSIRF) in Mental Health Settings - Investigation of Deaths & Serious Incidents
This timely conference will explore the practical aspects of patient safety incident investigation, learning from deaths in mental health services, the implementation of the Patient Safety Incident Response Framework (PSIRF) and recommendations from HSSIB. The day will provide the latest insights into best practices for patient safety incident investigation, including mortality governance and learning from deaths. In line with the HSSIB report, there will be presentations focusing on putting people at the heart of patient safety investigation, involving families and developing a culture of learning from mistakes.
