Integrating service user and practitioner expertise within a web-based system for collaborative mental-health risk and safety management

Christopher D. Buckingham*, Ann Adams, Laura Vail, Ashish Kumar, Abu Ahmed, Annie Whelan, Eleni Karasouli

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: To develop a decision support system (DSS), myGRaCE, that integrates service user (SU) and practitioner expertise about mental health and associated risks of suicide, self-harm, harm to others, self-neglect, and vulnerability. The intention is to help SUs assess and manage their own mental health collaboratively with practitioners. Methods: An iterative process involving interviews, focus groups, and agile software development with 115 SUs, to elicit and implement myGRaCE requirements. Results: Findings highlight shared understanding of mental health risk between SUs and practitioners that can be integrated within a single model. However, important differences were revealed in SUs' preferred process of assessing risks and safety, which are reflected in the distinctive interface, navigation, tool functionality and language developed for myGRaCE. A challenge was how to provide flexible access without overwhelming and confusing users. Conclusion: The methods show that practitioner expertise can be reformulated in a format that simultaneously captures SU expertise, to provide a tool highly valued by SUs. A stepped process adds necessary structure to the assessment, each step with its own feedback and guidance. Practice Implications: The GRiST web-based DSS ( links and integrates myGRaCE self-assessments with GRiST practitioner assessments for supporting collaborative and self-managed healthcare.
Original languageEnglish
Pages (from-to)1189-1196
Number of pages8
JournalPatient Education and Counseling
Issue number10
Early online date14 Aug 2015
Publication statusPublished - Oct 2015
EventInternational Conference on Communication in Healthcare - Amsterdam, Netherlands
Duration: 28 Sept 20141 Oct 2014

Bibliographical note

Communication in Healthcare: Best papers from the International Conference on Communication in Healthcare, Amsterdam, The Netherlands, 28 September - 1 October 2014


  • clinical decision support systems
  • cognitive modelling
  • collaborative healthcare
  • GRaCE
  • GRiST
  • mental health
  • risk assessment
  • self-management


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