Risk assessment and management of patients with self-neglect: a 'grey area' for mental health workers.

This study explores the perceptions and experiences of community mental health workers who assess and manage the risk of self-neglect and severe self-neglect in people with serious mental health problems. The initial literature review demonstrated a lack of material on this specific subject. Semi-structured interviews were undertaken with seven community mental health workers who met the criteria of being knowledgeable, skilled and credible practitioners. Data analysis was completed using thematic content analysis. Findings suggest that community mental health workers are operating in a number of areas where there is a distinct lack of clarity--'The Grey Areas'. The most important of these were the tolerance of workers to situations of self-neglect/severe self-neglect, policies, procedures and legislation, and definitions of self-neglect/severe self-neglect. The workers dealt with this lack of clarity by completing a detailed risk assessment, which then enabled them to manage the risk. However, the need to balance the safety needs of clients against their need to be treated as autonomous individuals presented a major dilemma for workers.