IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i14p7671-d597105.html
   My bibliography  Save this article

An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives

Author

Listed:
  • Cheryl Regehr

    (Factor-Inwentash, Faculty of Social Work, University of Toronto, Toronto, ON M5S 1A1, Canada)

  • Guy Enosh

    (School of Social Work, University of Haifa, Haifa 3498838, Israel)

  • Emily Bosk

    (School of Social Work, Rutgers University, New Brunswick, NJ 08901-8554, USA)

Abstract

Mental health professionals are frequently presented with situations in which they must assess the risk that a client will cause harm to themselves or others. Troublingly, however, predictions of risk are remarkably inaccurate even when made by those who are highly skilled and highly trained. Consequently, many jurisdictions have moved to impose standardized decision-making tools aimed at improving outcomes. Using a decision-making ecology framework, this conceptual paper presents research on professional decision-making in situations of risk, using qualitative, survey, and experimental designs conducted in three countries. Results reveal that while risk assessment tools focus on client factors that contribute to the risk of harm to self or others, the nature of professional decision-making is far more complex. That is, the manner in which professionals interpret and describe features of the client and their situation, is influenced by the worker’s own personal and professional experiences, and the organizational and societal context in which they are located. Although part of the rationale of standardized approaches is to reduce complexity, our collective work demonstrates that the power of personal and social processes to shape decision-making often overwhelm the intention to simplify and standardize. Implications for policy and practice are discussed.

Suggested Citation

  • Cheryl Regehr & Guy Enosh & Emily Bosk, 2021. "An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives," IJERPH, MDPI, vol. 18(14), pages 1-11, July.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:14:p:7671-:d:597105
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/14/7671/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/18/14/7671/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Regehr, Cheryl & Chau, Shirley & Leslie, Bruce & Howe, Phillip, 2002. "Inquiries into Deaths of Children in Care: The Impact on Child Welfare Workers and their Organization," Children and Youth Services Review, Elsevier, vol. 24(12), pages 885-902, December.
    2. Regehr, Cheryl & Hemsworth, David & Leslie, Bruce & Howe, Phillip & Chau, Shirley, 2004. "Predictors of post-traumatic distress in child welfare workers: a linear structural equation model," Children and Youth Services Review, Elsevier, vol. 26(4), pages 331-346, April.
    3. Munro, Eileen, 2005. "Improving practice: Child protection as a systems problem," Children and Youth Services Review, Elsevier, vol. 27(4), pages 375-391, April.
    4. Nouman, Hani & Enosh, Guy & Niselbaum-Atzur, Pnina, 2016. "The role of parental communication, child's wishes and child's gender in social workers' custody recommendations," Children and Youth Services Review, Elsevier, vol. 70(C), pages 302-308.
    5. Michael J. Camasso & Radha Jagannathan, 2013. "Decision Making in Child Protective Services: A Risky Business?," Risk Analysis, John Wiley & Sons, vol. 33(9), pages 1636-1649, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. de Haan, Irene & Connolly, Marie, 2014. "Another Pandora's box? Some pros and cons of predictive risk modeling," Children and Youth Services Review, Elsevier, vol. 47(P1), pages 86-91.
    2. Festinger, Trudy & Baker, Amy, 2010. "Prevalence of recalled childhood emotional abuse among child welfare staff and related well-being factors," Children and Youth Services Review, Elsevier, vol. 32(4), pages 520-526, April.
    3. Brian Littlechild & Susan Hunt & Chris Goddard & Judy Cooper & Barry Raynes & James Wild, 2016. "The Effects of Violence and Aggression From Parents on Child Protection Workers’ Personal, Family, and Professional Lives," SAGE Open, , vol. 6(1), pages 21582440156, January.
    4. Boonzaaier, Emma & Truter, Elmien & Fouché, Ansie, 2021. "Occupational risk factors in child protection social work: A scoping review," Children and Youth Services Review, Elsevier, vol. 123(C).
    5. Victor Grimaldi & Javier Pérez-Padilla & Miguel Ángel Garrido & Bárbara Lorence, 2019. "Assessment and Decision-Making in Child Protective Services: Risk Situations Kept-at-Home Versus Out-of-Home Care," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 12(5), pages 1611-1628, October.
    6. Kim, Hansung, 2011. "Job conditions, unmet expectations, and burnout in public child welfare workers: How different from other social workers?," Children and Youth Services Review, Elsevier, vol. 33(2), pages 358-367, February.
    7. Nadan, Yochay & Katz, Carmit & Zion, Tamar & Wertheimer, Aya, 2021. "High intensity parental dispute in the Jewish ultra-Orthodox community in Israel: Perspectives of social workers and disaffiliated parents," Children and Youth Services Review, Elsevier, vol. 120(C).
    8. McBeath, Bowen & Briggs, Harold E. & Aisenberg, Eugene, 2009. "The role of child welfare managers in promoting agency performance through experimentation," Children and Youth Services Review, Elsevier, vol. 31(1), pages 112-118, January.
    9. Camasso, Michael J. & Jagannathan, Radha, 2019. "Conceptualizing and testing the vicious cycle in child protective services: The critical role played by child maltreatment fatalities," Children and Youth Services Review, Elsevier, vol. 103(C), pages 178-189.
    10. Arruabarrena, Ignacia & De Paúl, Joaquín, 2012. "Improving accuracy and consistency in child maltreatment severity assessment in child protection services in Spain: New set of criteria to help caseworkers in substantiation decisions," Children and Youth Services Review, Elsevier, vol. 34(4), pages 666-674.
    11. McBeath, Bowen & Collins-Camargo, Crystal & Chuang, Emmeline & Wells, Rebecca & Bunger, Alicia C. & Jolles, Mónica Pérez, 2014. "New directions for research on the organizational and institutional context of child welfare agencies: Introduction to the symposium on “The Organizational and Managerial Context of Private Child Welf," Children and Youth Services Review, Elsevier, vol. 38(C), pages 83-92.
    12. Gambrill, Eileen D., 2005. "Decision making in child welfare: Errors and their context," Children and Youth Services Review, Elsevier, vol. 27(4), pages 347-352, April.
    13. Emily Keddell, 2014. "Current Debates on Variability in Child Welfare Decision-Making: A Selected Literature Review," Social Sciences, MDPI, vol. 3(4), pages 1-25, November.
    14. Wise, Karlissa & Carter, LaToya & Bamba, Leslie Alyssa & Barr, Rachel, 2024. "How Do Child Protective Service (CPS) Policies Keep Employees Safe: ACaseworker’s Perspective," Children and Youth Services Review, Elsevier, vol. 162(C).
    15. Griffiths, Austin & Royse, David & Walker, Robert, 2018. "Stress among child protective service workers: Self-reported health consequences," Children and Youth Services Review, Elsevier, vol. 90(C), pages 46-53.
    16. Biggart, Laura & Ward, Emma & Cook, Laura & Schofield, Gillian, 2017. "The team as a secure base: Promoting resilience and competence in child and family social work," Children and Youth Services Review, Elsevier, vol. 83(C), pages 119-130.
    17. Robichaud, Marie-Joëlle & Pullen Sansfaçon, Annie & Poirier, Marie-Andrée, 2020. "Decision making at substantiation in cases involving racialized families: Child protection workers’ perceptions of influential factors," Children and Youth Services Review, Elsevier, vol. 110(C).
    18. Molina, A. & Palacios, J. & Jiménez-Morago, J.M., 2019. "Do more severe incidents lead to more drastic decisions? A study of professional child protection decision making in Spain," Children and Youth Services Review, Elsevier, vol. 107(C).
    19. Beth Coulthard & John Mallett & Brian Taylor, 2020. "Better Decisions for Children with “Big Data”: Can Algorithms Promote Fairness, Transparency and Parental Engagement?," Societies, MDPI, vol. 10(4), pages 1-16, December.
    20. Michael J. Camasso & Radha Jagannathan, 2013. "Decision Making in Child Protective Services: A Risky Business?," Risk Analysis, John Wiley & Sons, vol. 33(9), pages 1636-1649, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:14:p:7671-:d:597105. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.