Dynamic Risk Monitoring

This tool should be used as a frequent assessment of a young person’s level of distress and mental health. It should be used at the request of the allocated clinician either daily or weekly. Daily risk monitoring should be for short periods of time only, if extended use is required then the level of mental health care should be reviewed urgently.

IF THE YOUNG PERSON HAS EXPRESSED ANY PLANS TO TAKE THEIR OWN LIFE IMMEDIATELY GO TO A&E.

Name of young person: ______

Member of staff: ______

Date and time of observation: ______

Frequency: Daily ______Weekly ______

Type of risk being monitored: Risk to self_____ Risk to others______

(please note that if both risk to self and others is being monitored then a separate form must be completed for each one).

1 / Level of emotional arousal
Consider demonstration of anxiety, anger, and sadness. / 0 / Emotionally stable
1 / Mildly upset and tearful
2 / Visibly upset and anxious/angry
3 / Highly distressed or emotionally flat
2 / Level of self-care
Consider eating, drinking, washing and appearance. / 0 / Appropriate self-care
1 / Needs some prompts
2 / Needs excessive motivation
3 / Very poor self-care
3 / Level of isolation
Consider time spent in bedroom, time in shared areas of the home, contact with others, willingness to leave the house/ got to school. / 0 / Rarely isolated
1 / Needs some prompts to spend time with others/ leave room
2 / Needs excessive motivation to leave room/ is isolated for majority of time
3 / Spends most of time alone, in bedroom/ refuses contact with others
4 / Level of distress
Consider episodes of dissociation, possible hallucinations, disorientation/ confusion. / 0 / Calm and coherent
1 / Some concerning behaviour
2 / Clear distress/ concerns
3 / Significant concerns
5 / Thoughts of harm to self or others
Consider actual reports of thinking about self-harm, suicide, wanting to die and talks of death, wanting to hurt others. / 0 / None expressed
1 / Expressed some thoughts that are easily distracted from
2 / Frequent thoughts which are hard to distract from
3 / Thoughts most or all of time
6 / Level of intentions to harm self or others
Consider here how much the young person has intentions to hurt themselves or someone else. / 0 / No reports
1 / Specific description of intention to harm
2 / Actively seeking or in possession of instrument of harm
3 / Clear plans to harm and has access to means to harm
7 / Evidence of planning to harm self or others
Consider here any evidence you may see of plans, including, storing tablets, hiding sharp items, unusual items going missing. / 0 / No concerns
1 / Making random threats
2 / Making specific threats and grabbing objects with which to self-harm
3 / Active preparation by secreting instrument of harm or making weapons
8 / Level of risk of serious injury to self or others
Consider here how likely it is that the planned or intended action could cause injury or death. / 0 / Minor scratching or hair pulling
1 / Deep cuts, burns, head-banging or other similar injuring actions
2 / Action likely to cause severe harm
3 / Potentially lethal
9 / Level of help-seeking
Consider here how active the young person is in seeking help and preventing serious injury. / 0 / Openly notifies someone of thoughts/ attempts prior to actions
1 / Notifies someone openly
2 / Passively notifies someone but doesn’t openly tell i.e. leave door open
3 / Conceals actions/ intentions/ thoughts
10 / Evidence of ability to self-soothe
Consider here how able the young person is to use helpful strategies to prevent escalation or deterioration of mood/ mental state. / 0 / Actively uses helpful strategies
1 / Is able to identify strategies and use them with support.
2 / Struggles to identify or use strategies without lots of support
3 / Is unable to manage impulses or soothe self.
Previous score
Current Score

Please note there are no ‘cut off’ scores. This tool should be used to help you think about a young person’s wellbeing and should be used alongside support from a member of the clinical team.

Any changes in the risk should be forwarded to the allocated clinician. If immediate concerns are present and a clinician is unavailable then immediate action should be taken, this will be to contact local CAMHS or go to A&E unless there is an alternative plan in place.

Has clinician been informed of score / Not Required / Yes:
Advice given: