HLSC654 - Balancing Risk in Recovery

Year

Credit points

Campus offering

Prerequisites

Teaching organisation

Unit rationale, description and aim

Recovery oriented practice in mental health is based on principles such of human dignity, rights and self-determination. There are circumstances where an individual's rights may be impacted as a result of assessment of perceived risk to themselves or others as defined by relevant legislation that directs clinical practice. Therefore, it is essential that mental health practitioners develop a sound understanding of the concept of risk in the context of their practice and how to provide safe, effective care for individuals with mental distress or who are experiencing crisis.

This unit will provide students with an opportunity to explore contemporary mental health practice in settings where consumer rights may be compromised as a result of perceived risks. Using a recovery-oriented approach, students will investigate and analyse information about safe, effective care for individuals with mental distress or who are experiencing crisis. Mental health legislation, local and national guidelines and procedures for minimising risk and harm will be explored, particularly in relation to systems and processes that protect the individual from neglect, danger, harm and abuse. Students will explore concepts relating to mutuality, negotiation, dignity and choice in decision making.

The aim of this unit is to prepare students to deliver safe, ethical and legal care to individuals experiencing mental distress or crisis within a recovery-oriented practice framework.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Identify contemporary legal and ethical practices in the management of individuals considered ‘at risk’ (GA2, GA5);

LO2 - Demonstrate knowledge a range of models and tools of risk assessment that build on individual and family strengths to promote their health and well-being (GA3, GA5, GA6);

LO3 - Utilise a range of communication skills to establish and maintain therapeutic relationships with individuals and their significant others during risk assessment and strategies that enables recovery and promotes a, collaborative and holistic recovery-oriented and trauma informed approach to risk assessment/management (GA1, GA9);

LO4 - Work in partnership with other disciplines, agencies and stakeholders to deliver holistic, evidence-based care that effectively assesses and negotiates risk strategies that meet ethical and legal standards pf practice and is respectful of the individual’s rights, choices, experiences and circumstances (GA1, GA7).

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA7 - work both autonomously and collaboratively 

GA9 - demonstrate effective communication in oral and written English language and visual media 

Content

Topics will include:

Legal and ethical constructs

• Mental health legislation
• Legal considerations in the care of individuals
• Ethical considerations
• Least restrictive practice within a recovery oriented approach

Use of therapeutic communication in risk assessment to enable recovery

• Non-coercive communication
• Supported decision making within the context of risk
• Approaches to enhance self determination
• Negotiation skills in challenging behaviour
• Reflection on practice

Models and tools in risk assessment

• Structured clinical judgment
• Risk assessment tools e.g. HCR-20 and START
• Assessment of risk within diverse social, cultural and family contexts

Management of risk and safety

• Mental health triage
• Crisis & crisis intervention
• Risk prediction, risk tolerance, and risk prevention
• The contemporary evidence base on the use of interventions inclusive of: seclusion/mechanical restraint, medication, special/constant observation

Therapeutic interventions to promote health and well being

• Acknowledgement of individual and family strengths
• Psychosocial interventions to manage risk e.g. psycho-education, cognitive behavioural therapy, mindfulness, motivational interviewing, family therapy

Working in partnerships

• Individual and family/carer partnerships
• Interagency and interdisciplinary collaboration

Learning and teaching strategy and rationale

The active learning approaches applied in this unit are flexible and inclusive, allowing students the opportunity to analyse and critically evaluate approaches to providing holistic recovery oriented care in the context of individuals considered ‘at risk’.

This unit utilizes an active learning approach whereby students will engage in readings and reflections, e-Module activities and opportunities to collaborate with peers in an online environment. This can involve, but is not limited to, on-line discussion forums, chat rooms, guided reading and webinars. In addition, learning e-modules and links to electronic readings will be provided on the learning environment online (LEO) to guide students’ reading and extend other aspects of online learning.

Through an online learning platform learning strategies will focus on creating a nexus between workplace clinical practice and a contemporary evidence base. Key learning strategies will involve facilitated webinars and web-based learning. Students will be expected to take responsibility for their learning and to participate actively within group activities.

Assessment strategy and rationale

The assessment strategy used allows for the progressive development of knowledge and skills necessary for the student to be able to interrogate the relevant literature and further development of contemporary practice in settings where individual consumer rights may be compromised due to perceived risk. The second assessment task will require students to demonstrate their understanding and critical analysis of current relevant legislation pertaining to their practice. The third assessment task will enable students to demonstrate their understanding of the complexities involved in understanding and incorporating risk assessment in the context of recovery-oriented and trauma informed practice

Overview of assessments

Representative texts and references

Coombs, T., Crookes, P., & Curtis, J. (2013). A comprehensive mental health nursing assessment: variability of content in practice. Journal of psychiatric and mental health nursing, 20(2), 150-155.

Evans, K., Nizette, D., & O’Brien, A. (2017). Psychiatric and mental health nursing (4th ed.). Chatswood, NSW: Elsevier Australia.

Fieldhouse, J., & Onyett, S. (2012). Community mental health and social exclusion: Working appreciatively towards inclusion. Action Research, 10(4), 356-372.

Foster, K., Marks, P., O'Brien. A. & Raeburn, T. (2020). Mental health in nursing, 5th ed. Elsevier 

Hercelinskjy, G. & Alexander, L. (2020). Mental health nursing: applying theory to practice. Cengage: Singapore.  

Hughes, S., & Peak, T. (2013). A Critical Perspective on the Role of Psychotropic Medications in Mental Health Courts. American Behavioral Scientist, 57(2), 163-173.

Jeffs, L., Rose, D., Macrae, C., Maione, M., & Macmillan, K.M. (2012). What near misses tell us about risk and safety in mental health care. Journal of Psychiatric and Mental Health Nursing, 19(5), 430-437.

Kolski, T.D. & Jongsma A.E. (2012). The crisis counseling and traumatic events treatment planner (2nd ed.). Hoboken, N.J: John Wiley & Sons, Inc.

Tee, S., Brown, J., & Carpenter, D. (Eds.) (2012) Handbook of mental health nursing. London: Hodder Arnold.