Suicide and self-harm risk management reviews
An independent psychiatric review of how suicide and self-harm risk was assessed and managed, whether the care met the standard of the time, and what difference reasonable care would probably have made. Free initial screening call and fixed fees with no hidden charges.
- Section 12(2) approved
- Claimant, defendant and SJE
- Judged without hindsight
How risk care is reviewed
These are among the most painful claims a solicitor handles, often brought by a family after a death, or by a patient after serious self-harm. Dr Pradhan reviews how the risk of suicide or self-harm was assessed and managed by psychiatric services, and gives an independent opinion on whether the care met the standard of reasonable psychiatric practice at the time.
The review covers the assessment of risk, observation and leave, the response to self-harm, discharge planning and follow-up. It considers what the clinicians knew or ought to have known at each point, and avoids judging decisions by an outcome that could not have been foreseen.
Dr Pradhan is section 12(2) approved and dual-accredited for claimant and defendant work.
What the review covers
Suicide and self-harm risk reviews commonly address:
- The assessment of risk at each contact, and what was recorded
- The response to self-harm, including review after a crisis presentation
- Observation levels and their review on the ward
- Leave and absconding
- The decision to discharge, and the discharge plan
- Follow-up after discharge, and missed contacts
- Information shared with families and other services
- Use of mental health legislation, admission and transfer
- Safety planning and the involvement of the patient
- Whether the care met the standard of reasonable practice at the time
- Whether reasonable care would probably have changed the outcome
- Joint statements, supplementary questions and second opinions
Send a short chronology of the care, the allegations and the relevant dates, and Dr Pradhan will say whether the issues fall within her expertise and, if they do, confirm a fixed fee.
Submit an enquiryThe moments a review looks at
Most claims turn on a small number of decisions. The review identifies them and examines each against the information available at the time.
After self-harm
Whether a psychosocial assessment was done, what it found and how it shaped the plan.
On the ward
Observation levels, leave decisions and the response to changes in mental state.
At discharge
Whether the decision and the plan were reasonable, and whether risks were communicated.
After discharge
Whether follow-up happened when it should have, and the response to missed contact.
Risk, hindsight and the legal tests
A death or serious injury does not mean the care was negligent. The question is whether the assessment and management of risk fell outside what a responsible body of psychiatrists would have accepted at the time, and if so, whether reasonable care would probably have prevented the harm. The report deals with both, and explains where reasonable clinicians could differ.
Where a patient died, close family members may also have a claim under the Human Rights Act 1998 for breach of Article 2. It raises different questions from negligence and has a one-year time limit, which the court can extend. For claims in England and Wales the report is structured for CPR Part 35 and Practice Direction 35; reports for Scotland and Northern Ireland are prepared to the requirements of those courts.
NICE advises against using risk assessment tools, scales or a low, medium or high rating to predict suicide or repeat self-harm, or to decide who receives treatment. Care should rest on an assessment of the person’s needs and risks.
Related pages
Risk review questions
If your question is not answered here, call and Dr Pradhan will advise on scope and timescale.
Call 0121 752 6065Does a death by suicide mean the care was negligent?
No. Suicide cannot always be predicted or prevented. The review asks whether the assessment and management of risk met the standard of reasonable practice at the time, and whether reasonable care would probably have changed the outcome.
Can the review be done when the patient has died?
Yes. The review is based on the records, the witness statements and, where there has been an inquest, the evidence given there.
Does Dr Pradhan review GP or emergency department care?
She reviews the psychiatric care. The standard of GP or emergency department care is for an expert in that field; she can comment on the psychiatric aspects.
Will the review consider the use of risk scores?
Yes, judged by the guidance in force at the time. Current NICE guidance advises against relying on risk scores or ratings to predict suicide or decide on treatment.
How long does a review take?
It depends on the volume of records. The timescale is confirmed at the outset, once the records and the allegations have been seen.
Instruct Dr Pradhan on a risk review
Send a short chronology of the care, the allegations, the funding route and any limitation or inquest dates.
- Phone0121 752 6065
- Emailinfo@
doctorpradhan.co.uk - Consulting Rooms NationwideAbacus Court, Harborne, Birmingham B17 0HH
Please do not include medical records or a detailed personal history in this form. Dr Pradhan will confirm how to send the papers once the instruction is agreed.
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If the matter is urgent, call 0121 752 6065.