Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA.
Institute of Cognitive Science, University of Colorado, Boulder, USA.
Community Ment Health J. 2019 Oct;55(7):1165-1172. doi: 10.1007/s10597-019-00411-x. Epub 2019 Jun 1.
Accurate prediction of risk-states in Serious Mental Illnesses (SMIs) is critical for reducing their massive societal burden. Risk-state assessments are notably inaccurate. Recent innovations, including widely available and inexpensive mobile technologies for ambulatory "biobehavioral" data, can reshape risk assessment. To help understand and accelerate clinician involvement, we surveyed 90 multi-disciplinary clinicians serving SMI populations in various settings to evaluate how risk assessment is conducted and can improve. Clinicians reported considerable variability in conducting risk assessment, and few clinicians explicated their procedures beyond tying it to broader mental status examinations or interviews. Very few clinicians endorsed using currently-available standardized risk measures, and most reported low confidence in their utility. Clinicians also reported spending approximately half the time conducting individual risk assessments than optimally needed. When asked about improvement, virtually no clinicians acknowledged biobehavioral, objective technologies, or ambulatory recording. Overall, clinicians seemed unaware of meaningful ways to improve risk assessment.
准确预测严重精神疾病（SMI）的风险状态对于减轻其巨大的社会负担至关重要。风险状态评估明显不够准确。最近的创新，包括广泛可用且价格低廉的移动技术，用于门诊的“生物行为”数据，可以重塑风险评估。为了帮助理解并加速临床医生的参与，我们调查了 90 名服务于各种环境中的 SMI 人群的多学科临床医生，以评估风险评估的开展情况以及如何进行改进。临床医生报告说，在进行风险评估时存在相当大的差异，而且很少有临床医生除了将其与更广泛的精神状态检查或访谈联系起来之外，还详细说明了他们的程序。很少有临床医生认可使用当前可用的标准化风险测量方法，而且大多数人报告说对其效用缺乏信心。临床医生还报告说，他们进行个体风险评估的时间大约只有最佳所需时间的一半。当被问及改进时，几乎没有临床医生承认生物行为、客观技术或动态记录。总的来说，临床医生似乎不知道有意义的方法来改进风险评估。
