27:T520,

The Dynamic Appraisal of Situational Aggression (DASA) is a tool designed to assess the risk of violence in inpatient adult mental healthcare. Despite its empirical support, there is limited understanding of how the DASA is used to guide risk management. We interviewed twelve nursing staff across two forensic hospitals, exploring how the tool is operationalised and how nursing staff use the DASA score to guide their risk management. In the services studied, the DASA was being used as intended to assess violence risk. A key theme was the use of the DASA to share risk information, the initial step of the pathway from assessment to risk management. When integrating the DASA output with risk management, the DASA prompted nurses to undertake further assessment and/or put patient care plans into action, rather than choose an intervention stratified from the DASA score. The findings identify an important consideration of whether an assessment tool is designed to structure one's judgement (whilst not entirely displacing the user's experience and knowledge), or whether the tool needs to prescriptively guide clinical decision-making. This study builds an understanding of how risk assessment tools are implemented in real-world practice and the pathway from risk assessment to management outcomes.

28:T514,

Public involvement in research is advocated by research authorities and funding bodies worldwide. In the United Kingdom (UK), it is considered achievable and expected in all types of health and social care research. However, lived-experience involvement in prison and forensic mental health research remains rare. This qualitative study reports the experiences of National Health Service (NHS) staff, probation staff, and people with lived experience collaborating in a unique research group within a secure mental health setting in England. Qualitative interviews were undertaken with six staff and four lived-experience researchers. Reflexive thematic analysis was applied, supported by NVivo software. Two themes were identified: Relationship Matters and This Feels Valuable, each with two subthemes: Balancing the Scales and Safe and Secure; and Collaboration Improves Our Research, but It's Challenging and Personal and Professional Growth. This study provides evidence that collaborative research can benefit forensic mental health settings and outlines factors that contributed to positive experiences for the researchers. There was lived-experience involvement throughout this study.

29:T5a8,