Leanne Gregory, Principal Clinical Psychologist, IVY Heather Irving, Social Worker CYCJ/IVY

1. The Scottish High Risk Mental HealthYouth Project (IVY)– Key Findings andMessages for Practice Leanne Gregory, Principal Clinical Psychologist, IVY Heather Irving, Social Worker CYCJ/IVY Nota Scotland Conference 29th April 2014

4. The Challenges

5. The rest of IVY Stuart Allardyce Dr Lorraine Johnstone

6. Our Aims

7. IVY

8. The Model

9. Framework for Risk Assessment Management and Evaluation (FRAME) http://www.rmascotland.gov.uk/standardsandguidelines/

10. Structured Professional Judgement

11. Risk Formulation Formulation is the summation and integration of the knowledge that is acquired by the assessment process (which may involve a number of different procedures). This will draw on psychological theory and data to provide a framework for describing a problem, how it developed and is being maintained” Division of Clinical Psychology 2001; cited Johnstone & Dallos (2006)

12. Risk Formulation Formulation is not a new or novel concept in general terms; it is used in each of the main models of psychotherapy – behavioural, cognitive-behavioural, psychodynamic, systemic and integrative approaches - these are theoretically guided or model specific forms of formulation.

13. Risk Formulation No single theory or model of violence exists therefore A pragmatically guided formulation has more utility in risk assessment

14. 4 P’s Approach • predisposing (i.e., factors in the individual’s past that may increase his proclivity or vulnerability to violence) • precipitating (i.e., events or circumstances that may trigger the behaviour or disinhibit usual behavioural controls); (motivators, disinhibitors) • perpetuating (i.e., factors that cause the risk to remain) (impeders, unresolved vulnerabilities) • protective factors (i.e., aspects of the offender’s functioning or circumstances that moderate the risk)

15. Who is referring? 25 referrals 1 police 5health 19 social work

16. 2 1 1 2 1 2 1 2 3 5 1 4 Map of Scotland provided courtesy of FreeVectorMaps.com

17. Demographics – Age & Sex N= 25 Mean age = 15.5 Mode = 16 Range 12-17 Male = 19 Female = 6

18. Accommodation

19. Domestic Violence

20. Other Maltreatment

21. MEAN = 4.4

22. Firesetting Violent Extremism Victimisation Sexual offence - contact PRIMARY RISK N = 17 Suicide /DSH Interpersonal Violence Sexual offences non-contact

23. Sexual offences non-contact Firesetting SECONDARY RISK Suicide /DSH Victimisation Interpersonal violence

24. Comorbid Risks 64%

25. Level 2 10 offered 9 accepted Risk Assessment Learning Disability Personality Mental Health Diagnostic Review

26. Emerging Themes

27. Reflections and Discussion