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Risk Assessment

Risk Assessment

Introduction

This tool helps primary care providers determine whether a patient with intellectual and developmental disability (IDD) who is experiencing a crisis (e.g., emotional or behavioural distress) can be managed safely in their current living or work environment or should be referred to the emergency department or crisis care. It considers the risk to self and to others (e.g., peers and caregivers) during an escalation in the context of available supports. It helps identify unique risk and protective factors

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Clinical leads

Elspeth Bradley, MB BS PhD FRCPC FRCPsych, is a psychiatrist and psychotherapist in intellectual and developmental disabilities (IDD). She is an Associate Professor at the University of Toronto and currently holds courtesy appointments at The Centre for Addiction and Mental Health and at St Michael’s Hospital, Toronto. Dr. Bradley has had the pleasure of contributing to the Developmental Disabilities Primary Care Program since its inception in 2005 and of working with people with intellectual and developmental disabilities and autism (ASD) for several decades in the UK and Canada. Her current focus on trauma, triggers and emotional engagement as a necessary pre-requisite to any psychiatric evaluation, is described in a recently co-authored book Responsive Communication: Combining attention to sensory issues with using body language (intensive Interaction) to interact with autistic adults and children

Kerry Boyd, MD FRCPC, Associate Clinical Professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, Ontario. Her clinical work includes working with people who have developmental disabilities. Education and research initiatives have focused on promoting inclusion and care for people with IDD. As an AMS Phoenix Fellow she brought expertise together as Curriculum of Caring course developer. More information on the Curriculum of Caring.

Anupam Thakur, MBBS, MD, MSc (medical education) is the Psychiatrist-in-Chief at Surrey Place, Toronto, and staff psychiatrist and education scholar at Centre for Addiction and Mental Health. Dr. Thakur is an Assistant Professor in the Department of Psychiatry at the University of Toronto. He is also the co-chair of the Developmental Disabilities section in Canadian Psychiatric Association. His research interests are focussed on building capacity and expertise in intellectual and developmental disabilities, leadership development and enhancing medical education using technology.

Authors

Laurie Green, MD, CCFP(EM), FCFP, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario

Maureen Kelly, MPA, nurse (retired)

Yona Lunsky, Ph.D., C.Psych, Senior Scientist, Director of the Azrieli Adult Neurodevelopmental Centre, and Director, Centre for Addiction and Mental Health, Toronto; Full Professor, Department of Psychiatry, University of Toronto; Adjunct Scientist, ICES, Toronto

Karen McNeil, MD, CCFP, FCFP, family physician and Assistant Professor, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia

Ullanda Neil, MD, CCFP, Scarborough, Ontario

Alicia Thatcher, MD, CCFP, Regina, Saskatchewan

William Sullivan, MD, CCFP(COE), FCFP, PhD, Joseph P. Kennedy Sr. Chair in Bioethics, Senior Research Scholar, Kennedy Institute of Ethics; Full Professor of Family Medicine, Georgetown University

This is an update to a previous version of this tool, published as Risk Assessment Tool for Adults with DD in Behavioural Crisis, in: Sullivan WF, Developmental Disabilities Primary Care Initiative Scientific and Editorial Staff, editors. Tools for the primary care of people with developmental disabilities. Toronto: MUMS Guideline Clearing House; 2011, p.66.

  • Meet the team

    Clinical leads

    Elspeth Bradley, MB BS PhD FRCPC FRCPsych, is a psychiatrist and psychotherapist in intellectual and developmental disabilities (IDD). She is an Associate Professor at the University of Toronto and currently holds courtesy appointments at The Centre for Addiction and Mental Health and at St Michael’s Hospital, Toronto. Dr. Bradley has had the pleasure of contributing to the Developmental Disabilities Primary Care Program since its inception in 2005 and of working with people with intellectual and developmental disabilities and autism (ASD) for several decades in the UK and Canada. Her current focus on trauma, triggers and emotional engagement as a necessary pre-requisite to any psychiatric evaluation, is described in a recently co-authored book Responsive Communication: Combining attention to sensory issues with using body language (intensive Interaction) to interact with autistic adults and children

    Kerry Boyd, MD FRCPC, Associate Clinical Professor in the Department of Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, Ontario. Her clinical work includes working with people who have developmental disabilities. Education and research initiatives have focused on promoting inclusion and care for people with IDD. As an AMS Phoenix Fellow she brought expertise together as Curriculum of Caring course developer. More information on the Curriculum of Caring.

    Anupam Thakur, MBBS, MD, MSc (medical education) is the Psychiatrist-in-Chief at Surrey Place, Toronto, and staff psychiatrist and education scholar at Centre for Addiction and Mental Health. Dr. Thakur is an Assistant Professor in the Department of Psychiatry at the University of Toronto. He is also the co-chair of the Developmental Disabilities section in Canadian Psychiatric Association. His research interests are focussed on building capacity and expertise in intellectual and developmental disabilities, leadership development and enhancing medical education using technology.

    Authors

    Laurie Green, MD, CCFP(EM), FCFP, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario

    Maureen Kelly, MPA, nurse (retired)

    Yona Lunsky, Ph.D., C.Psych, Senior Scientist, Director of the Azrieli Adult Neurodevelopmental Centre, and Director, Centre for Addiction and Mental Health, Toronto; Full Professor, Department of Psychiatry, University of Toronto; Adjunct Scientist, ICES, Toronto

    Karen McNeil, MD, CCFP, FCFP, family physician and Assistant Professor, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia

    Ullanda Neil, MD, CCFP, Scarborough, Ontario

    Alicia Thatcher, MD, CCFP, Regina, Saskatchewan

    William Sullivan, MD, CCFP(COE), FCFP, PhD, Joseph P. Kennedy Sr. Chair in Bioethics, Senior Research Scholar, Kennedy Institute of Ethics; Full Professor of Family Medicine, Georgetown University

  • Version history

    This is an update to a previous version of this tool, published as Risk Assessment Tool for Adults with DD in Behavioural Crisis, in: Sullivan WF, Developmental Disabilities Primary Care Initiative Scientific and Editorial Staff, editors. Tools for the primary care of people with developmental disabilities. Toronto: MUMS Guideline Clearing House; 2011, p.66.

All rights reserved. No part of this website may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior written permission of the copyright owner, Surrey Place. Contact the Developmental Disabilities Primary Care Program at Surrey Place at ddpcp@surreyplace.ca for permission to adapt information and tools to your local practice setting.