GRiST features:

GRiST explicitly models structured clinical judgements of mental-health experts

  • based on expertise obtained from multidisciplinary mental-health clinicians
  • where rigorous research methods were used for eliciting consensual clinical expertise
  • with a clear audit trail demonstrating the evidence base for the risk model

GRiST is a validated model of hierarchical risk expertise which

  • links risk data to top-level risks through intervening concepts
  • provides a precise formal structure and location for each piece of service-user data
  • acts as an index to risk information held in other patient documentation to facilitate its linkage and collation
  • has potential to populate information in other patient records and avoid double data entry
  • makes it easy to find any piece of information and format it for reports

GRiST integrates empirical evidence with structured clinical judgements

  • within a single system
  • using the accumulating database of risk data and judgements
  • in accordance with Department of Health guidance

GRiST is underpinned by a database with statistical and pattern
recognition tools. On-going analyses will contribute to the research evidence base about

  • how clinicians assess risk
  • social patterns and inequalities associated with risk assessment
  • risk prediction

GRiST was developed from the start to exploit the semantic web with

  • flexible formatting of information
  • multiple delivery modes and web-based interfaces
  • easy and universal access
  • ongoing resources for rapid adaptation in response to changing clinical
    needs, government directives, and IT requirements

GRiST is designed as an interactive tool with sophisticated interface functionality with

  • streamlined data entry with questions displayed only when relevant
  • no need to re-enter data that will not change (i.e. persistent/historical
    data) for subsequent patient assessments (e.g. date of first suicide attempt)
  • automatic output of reports from the data entered that can be individually
    customised for the particular clinical service
  • the facility to add comments or narrative to any piece of risk data or to
    contextualise risk judgments

GRiST has versions for different populations

  • based on the same validated underlying knowledge structure
  • where data are easily passed between population groups, currently including:
    • working-age adults
    • CAMHS
    • older adults
    • service users for self assessment

GRiST is based on psychological knowledge structuring and reasoning processes,
which enables risk advice to be explained in ways that are

  • easy to understand
  • easy to validate
  • supporting judgements, not blind faith

GRiST is explicitly intended to support shared decision making and self-assessment

  • via a service-user version
  • as it is accessible via IAPT, primary care, and other front-line services or public
  • facilities such as libraries and mental-health charities

GRiST represents a common risk language with multiple interfaces for collecting
information and providing advice that

  • reflects the needs of different assessors in different contexts
  • is all linked to the same underlying model of risk

GRiST provides a whole (health and social care) system approach to risk
assessment that aids risk communication across the entire care pathway, from the community
to specialist secondary mental-health services. It supports conncection between

  • different services
  • different care sectors
  • clinicians, service users and their carers

GRiST creates opportunities for NHS organisations to collaborate on research
projects with the GRiST R&D teambecause it is

  • based in two research-intensive universities (Warwick and Aston)
  • founded on the philosophy of generating rigorous research
    evidence for its development coupled with extensive clinical testing at the point of care