Table 2 Characteristics of included studies

Coffey et al. (2017) [20]

Linked papers (Simpson et al., 2016a [75], Simpson et al., 2016b [76])

To examine what patients, family members and workers say about risk assessment and management.

UK

N = 67

Community mental health teams

Senior managers (N = 12); Senior practitioners (N = 27);

Care coordinators (N = 28)

Semi-structured interviews

Thematic analysis

Key Paper

Gunstone (2003) [70]

To explore the experiences and perceptions of community mental health workers in assessing and managing the risk of self-neglect or severe self-neglect in people with serious mental health problems.

UK

N = 7

Community mental health team and assertive outreach team

Community mental health workers (N = 7)

Semi-structured interviews

Thematic content analysis

Satisfactory

Holley et al. (2016) [72]

To explore how risk management practice impacts upon the implementation of recovery- oriented care within community mental health services.

UK

N = 8

Community mental health teams

Social worker

(N = 3); Occupational therapist (N = 1); Nurse (N = 2); Psychiatrist (N = 2)

Semi-structured interviews using vignettes

Grounded theory

Key Paper

Langan (2008) [16]

Linked publication (Langan and Lindow, 2004 [42])

To explore how MHPs assessed risk to others and the extent to which they involved service users. To ascertain service users’ knowledge of, and involvement in, risk assessment.

UK

N = 46

Adult psychiatric inpatient setting

Psychiatrist (N = 14);

Nursing (N = 22); Social worker (N = 5); Psychologist (N = 2); Occupational therapist (N = 1); Unqualified (N = 2)

Semi-structured interviews

Thematic analysis

Key Paper

Woods (2013) [63]

To identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units

Canada

N = 48

Adult inpatient mental health and forensic units

Psychiatric Nurse (N = 33); Registered Nurse (N = 2);

Licensed Practical Nurse (N = 1); Special Care Aide (N = 7); Social Worker (N = 2);

Student Nurse (N = 1); Other

(N = 2)

Focus groups

Thematic analysis

Satisfactory

Barnicot et al. (2017) [71]

Linked paper (Insua-Summerhays et al., 2018 [77])

To understand how staff and patients experience negotiating the balance between privacy and safety during decision-making about continuous observation.

UK

N = 31

Adult psychiatric inpatient setting

Nursing (N = 9)

Unqualified nursing staff (N = 12); Clinical team leader (N = 2); Ward manager (N = 3); Modern matron (N = 1); Consultant psychiatrist (N = 3); Consultant clinical psychologist (N = 1)

Semi-structured interviews

Thematic analysis

Key Paper

Felton et al. (2018) [66]

Linked paper

(Felton et al., 2018) [78]

To examine MHPs’ experiences of potential contradictions between promoting recovery and managing risk in decision-making.

UK

N = 17

Acute inpatient ward and assertive outreach team

Mental health nurse (N = 4); Ward charge nurse (N = 1); Consultant psychiatrist (N = 3); Community mental health nurse (N = 7); Community support worker (N = 1); Support worker team manager (N = 1)

Unstructured observations and semi-structured interviews

Case study theory building approach

Key Paper

Awenat et al. (2017) [81]

To investigate the experiences and perceptions of staff working with in-patients who are suicidal

UK

N = 20

Adult psychiatric inpatient setting

Qualified nurse (n = 8); Nursing assistant/support worker (N = 2); Psychiatry (N = 4); Allied health professional (N = 6)

Semi-structured interviews

Thematic analysis

Key Paper

Sun et al. (2006) [67]

To explore and examine psychiatric nurses’ and patients’ perceptions of the care offered to patients with suicidal ideations on psychiatric wards

Taiwan

N = 15

Acute psychiatric ward and psychiatric

stress ward

Registered Nurses (N = 15)

Participant observation and semi-structured interviews

Grounded theory

Satisfactory

Forsberg et al. (2018) [60]

To examine the processes involved in clinicians’ decision-making, specific to neuroleptic discontinuation.

UK

N = 12

Adult community mental health team, early intervention service or recovery team

Psychiatrist (N = 5); Mental Health Nurse (N = 7)

In-depth interviews

Grounded theory

Satisfactory

Vandewalle et al. (2019a) [82]

To uncover and understand the core elements of how nurses on psychiatric wards make contact with patients experiencing suicidal ideation.

Belgium

N = 19

Adult psychiatric wards

Nurses (N = 19)

Semi-structured

interviews

Grounded theory

Key paper

Nielsen et al. (2018) [61]

To report on forensic mental health clinicians’ experiences of the clinician-patient alliance during mechanical restraint.

Denmark

N = 17

Forensic mental health setting: secure unit and rehabilitation unit

Nurse Assistant (N = 1)

Social and Healthcare Assistant (N = 8)

Nurse (N = 8)

Focus groups

Thematic analysis

Satisfactory

Nyman et al. (2020) [64]

To explore mental health nurses’ experiences of risk assessments within their care planning and management of risks for violence by forensic patients.

Sweden

N = 15

Forensic psychiatric

Wards

Mental Health Nurse (N = 15)

Focus groups

Content analysis

Satisfactory

Rimondini et al. (2019) [65]

To investigate the critical issues and strategies related to psychiatric patients’ empowerment in risk management.

Italy

N = 95

Various mental health settings

Psychiatric nurse (N = 67); Healthcare and Social Assistance Operator (N = 10); other mental health professional, e.g., Psychiatrists, clinical psychologists, (N = 18).

Focus groups

Content analysis

Key paper

Vandewalle et al. (2019b) [83]

To uncover and understand the actions and aims of nurses in psychiatric hospitals during their interactions with patients experiencing suicidal ideation.

Belgium

N = 26

Adult psychiatric wards

Nurse (N = 26)

Semi-structured

interviews

Grounded theory and constant comparison analyses

Key paper

Coffey et al. (2019) [62]

To explore participants’ views and experiences of care planning and co-ordination, safety and risk, recovery and personalisation, and the context within which these operated.

UK

N = 31

Acute inpatient ward

Nurses, ward managers, occupational

therapists, psychologists and psychiatrists (N = 31)

Semi-structured interviews

Framework method

Satisfactory

Lees et al. (2014) [69]

To explore the experiences and needs that mental health care consumers had of suicidal crisis, the degree to which those needs were met, the role that mental health nurse engagement played in that context, and the key factors suggested to impact on the quality of care.

Australia

N = 11

Adult inpatient and community settings

Mental Health Nurse (N = 11)

Semi-structured interviews

Critical discourse, constant comparative and content analysis

Satisfactory

Hagen et al. (2017) [74]

Linked papers (Hagen et al., 2017a [79], Hagen et al., 2017b [80])

To explore and compare therapists’ and mental health nurses’ experiences of caring for suicidal inpatients in light of ethics of care and ethics of justice.

Norway

N = 16

Inpatient psychiatric wards

Psychiatrist (N = 4); Psychologist (N = 4); Mental Health Nurse (N = 8)

Semi-structured interviews

Systematic text condensation and theoretically scrutinized

Satisfactory

Fletcher (1999) [68]

To identify the way nurses perceive the purpose, nature and meaning of constant observation.

UK

N = 12

Inpatient psychiatric wards

Registered Nurses (N = 4); Enrolled Nurses (N = 2); Student Nurses (N = 2); Nursing Auxiliaries (N = 4)

Participant observations and interviews

Content analysis

Satisfactory

Nolan and Quinn (2012) [73]

To explore the reality of the everyday

practice of mental health social work professionals in managing the risks service users with mental health issues face and present.

UK

N= 7

Community mental health teams

Social workers (N = 7)

Semi-structured interviews

Grounded

theory and the constant comparative method

Satisfactory