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An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives
Mental health professionals are frequently presented with situations in which they must assess the risk that a client will cause harm to themselves or others. Troublingly, however, predictions of risk are remarkably inaccurate even when made by those who are highly skilled and highly trained. Conseq...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305590/ https://www.ncbi.nlm.nih.gov/pubmed/34300121 http://dx.doi.org/10.3390/ijerph18147671 |
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author | Regehr, Cheryl Enosh, Guy Bosk, Emily |
author_facet | Regehr, Cheryl Enosh, Guy Bosk, Emily |
author_sort | Regehr, Cheryl |
collection | PubMed |
description | Mental health professionals are frequently presented with situations in which they must assess the risk that a client will cause harm to themselves or others. Troublingly, however, predictions of risk are remarkably inaccurate even when made by those who are highly skilled and highly trained. Consequently, many jurisdictions have moved to impose standardized decision-making tools aimed at improving outcomes. Using a decision-making ecology framework, this conceptual paper presents research on professional decision-making in situations of risk, using qualitative, survey, and experimental designs conducted in three countries. Results reveal that while risk assessment tools focus on client factors that contribute to the risk of harm to self or others, the nature of professional decision-making is far more complex. That is, the manner in which professionals interpret and describe features of the client and their situation, is influenced by the worker’s own personal and professional experiences, and the organizational and societal context in which they are located. Although part of the rationale of standardized approaches is to reduce complexity, our collective work demonstrates that the power of personal and social processes to shape decision-making often overwhelm the intention to simplify and standardize. Implications for policy and practice are discussed. |
format | Online Article Text |
id | pubmed-8305590 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83055902021-07-25 An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives Regehr, Cheryl Enosh, Guy Bosk, Emily Int J Environ Res Public Health Article Mental health professionals are frequently presented with situations in which they must assess the risk that a client will cause harm to themselves or others. Troublingly, however, predictions of risk are remarkably inaccurate even when made by those who are highly skilled and highly trained. Consequently, many jurisdictions have moved to impose standardized decision-making tools aimed at improving outcomes. Using a decision-making ecology framework, this conceptual paper presents research on professional decision-making in situations of risk, using qualitative, survey, and experimental designs conducted in three countries. Results reveal that while risk assessment tools focus on client factors that contribute to the risk of harm to self or others, the nature of professional decision-making is far more complex. That is, the manner in which professionals interpret and describe features of the client and their situation, is influenced by the worker’s own personal and professional experiences, and the organizational and societal context in which they are located. Although part of the rationale of standardized approaches is to reduce complexity, our collective work demonstrates that the power of personal and social processes to shape decision-making often overwhelm the intention to simplify and standardize. Implications for policy and practice are discussed. MDPI 2021-07-19 /pmc/articles/PMC8305590/ /pubmed/34300121 http://dx.doi.org/10.3390/ijerph18147671 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Regehr, Cheryl Enosh, Guy Bosk, Emily An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives |
title | An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives |
title_full | An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives |
title_fullStr | An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives |
title_full_unstemmed | An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives |
title_short | An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives |
title_sort | ecological model for high-risk professional decision-making in mental health: international perspectives |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305590/ https://www.ncbi.nlm.nih.gov/pubmed/34300121 http://dx.doi.org/10.3390/ijerph18147671 |
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