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Table 1 An illustrative sample of how three stakeholders ranked the order in which the risks identified should be prioritised for the purposes of phase 2 review and synthesis

From: Using the nominal group technique to involve young people in an evidence synthesis which explored ‘risk’ in inpatient mental healthcare

1. Bad influences, unhelpful friendships, new peer norms

2. Imitating other patients

3. Attitudes of staff/therapists, dysfunctional systems, lack of staff training to deal with

such behaviour

4. Early discharge/making decisions about discharge without consulting patient

5. Not acknowledging risk factors that are important to the young person’s wellbeing

6. Transition back into community/adult services. Not enough planning or coping strategies

in place to help patient

7. Unable to engage with staff members/being isolated increases bad feelings,

disempowerment of family members

1. Self-injury

2. Suicide

3. Disempowerment/distress/no responsibility towards self, no motivation to recover

4. Violence from patients

5. Unhelpful friendship with other young people on the unit

6. Having a new network of friends that all have mental health problems

7. Contagion: learning and emulating behaviours witnessed in other patients

8. Risk to education

9. Stigma on return to mainstream education

10. Unmonitored visitors taking advantage of young people’s vulnerability (abuse)

1. Losing ‘normal’ identity

2. Not having the chance to achieve educationally

3. Risk adverse culture leads to lack of progress and increased readmission

4. Risk of losing connection to social group leads to a longer recovery time