RISK
RAMAS: The PARTNERSHIP Approach to Risk, Need and Responsivity
Risk Assessment Management Audit Systems
‘Helping you assess, manage and audit risk’
What is RAMAS?
Risk Assessment Management and Audit Systems known as RAMAS - was developed with UK Department of Health funding to achieve the twin objectives of providing better protection for the public whilst improving care planning, treatment and management of people posing risk to themselves or others. RAMAS is cited as an example of good practice in the White Paper "Reforming the Mental Health Act." (DoH December 2000)
Using evidence based Frameworks and Tools, RAMAS helps you assess manage and audit risk, need and responsivity.
It measures four areas:
- Risk to Self
- Risk to Others
- Mental Instability
- Vulnerability
The purpose of RAMAS National, Standardised Frameworks and Tools:
Who is it for?
RAMAS is a multi-agency care process. It can be integrated into standard care management and the care programme approach, it is suitable for use in hospital and community settings, in research, health , social, housing and probation practice.
RAMAS is suitable for use with everyone who comes into contact with mental health, criminal Justice, social services, housing and other agencies. Previous participants in training courses have included psychiatrists, psychologists, GPs, social workers, probation officers, housing officers, police and service users.
The Philosophy:
RAMAS is concerned in managing Risk in a way that provides improved opportunities for individuals, families and services to deal with the consequence of mental-ill health and emotional vulnerability.
RAMAS provides:
- Simple, structures and standardised frameworks for Risk, Need & Care.
- A positive, skills building approach.
- A nationally recognised, evidence based robust risk assessment, care management and audit system.
- A mechanism to clarify and agree roles and responsibilities across disciplines & agencies involved in treatment and care.
- A clarified and agreed confidentiality information system between agencies.
- Clear shared goals and fail safety systems. (Risk escalation is prevented)
- Multi-level, multi sourced multi agency assessment and care. (Needs Led)
- Accurate, complete, user focused safety and support. (Responsivity addressed upfront)
RAMAS uses a common language which can be understood and utilised by the client, his/her family and by all agencies involved in individual care and public safety.
Technical:
Risk Assessment, Management and Audit Systems ( RAMAS )
Key References : 33,41,42
Origin: England ( also used in Wales, Scotland & Northern Ireland )
Scope: An evidence based approach to risk and care. Framework and Tools designed to improve quality and safety in Mental Health Service provision. Conforms to National Service Frameworks and CNST standards.
Target Behaviours: Designed to cover the full range of risk, need & responsivity. Covers :1. Risk to self, 2. Risk to others, 3. Mental Health Risk, 4. Vulnerability.
Focus: Integrates risk and care. Monitoring & Management CommunicationTools. Common Language/ National system. Alert and early warning communication tools.
Development: Funded by DOH and by Service Users charity. Developed in Mental Health and Social Care. Validated in Community and Hospital Mental Health sites, multi-disciplinary and inter agency. Service users, carers and Voluntary agencies involved in Design and Development.
Approach: Structured Professional judgement (SPJ) integrated risk and care management tools. Holistic, Biopsychosocial approach maps on to CPA and OaSys. Positive, Proactive, Capability Building Ethos.
Target Population: Built around People (service users and carers) not services or systems. Suitable at all level of Mental Health Service provision.
Evidence Base: Risk Assessment Checklist is psychometrically robust. Reliability and validity demonstrated (Ref. 33). The structure of Risk as a cumulative process is demonstrated giving clear construct validation. Clinical expertise from mental health professionals in practice. Patient values addressed through Service User’s Charter, Carer’s and client’s consent forms. Researched.
Training and Support: ( 3 Levels )
Level 1. Start Safe…Stay Safe Programme. Risk recognistion & Communication, suitable for all staff, Ref 42.
Level 2. Risk & care management, suitable for clinicans/Practitioners, Maps on to CPA.
Level 3. Training the Trainers, experienced Level 2 users & Risk Managers
I.T. Electronic version of RAMAS under development. Suitable for Automation through National Patient records. Compatible with CPA and OASys.