What Makes Someone “At Risk”?

Here at Lincoln Prairie, our main focus is stabilizing youth who are at risk of hurting themselves or someone else.  A patient who comes to us has likely had this risk assessed several times.  It may initiate at school, then a crisis response team is called, then they are assessed again at intake to our hospital and once again by their therapist as an individual treatment plan is formed.  There is even a final assessment that compares the patient’s level of risk with how it was upon entry.

The word “risk” is used in a wide range of settings, whether it is related to health concerns, financial investments, safety concerns, gambling or more. But, what does “at risk” mean?

The term “at risk” refers to individuals or groups who face a higher likelihood of experiencing negative outcomes due to certain vulnerabilities. These risks can stem from socioeconomic challenges such as poverty or unstable housing, health issues like chronic illness or mental health concerns, and environmental factors including unsafe neighborhoods or limited access to resources. In education, “at risk” often describes students who may struggle academically or drop out, while in public health it applies to those more likely to develop diseases. Social services use the term for people susceptible to harm or exploitation due to family instability, lack of support, or behavioral challenges. Overall, being “at risk” means having conditions that increase exposure to adverse consequences compared to the general population.

An education piece I often present to groups is called “LGBTQ Issues in Mental Health”.  Continued education in this field reveals that members of the LGBTQIA+ community are “at risk”.  People who are LGBTQ are at greater risk to have violence perpetrated on them.  LGBTQ students report a higher incidence of bullying.  Members of the community have more difficulty finding housing, healthcare providers and social or spiritual connections.

Another topic of education I offer covers teen suicide and depression.  Much of the material revolves around risk factors that can make someone more likely to be depressed or have suicidal thoughts.  In this case, these risk factors are clues that help identify someone who is more likely to experience suicidal ideation and depression and therefore can focus prevention efforts on those individuals.

In a broader scope, however, people who are at risk can be almost anyone, depending on the circumstance.  Children are at high risk for many things including trauma, accidents, manipulation, influencing, certain physical and mental health issues and environmental factors to name a few.  People of color often face higher risks than their white counterparts. Women, religious groups, people who are disabled, the elderly, people with intellectual disabilities and people of lower socio-economic status all face greater challenges that put them “at risk” more often than some of their counterparts.

When we’re dealing with any individual, it is critical that we try to identify as many risk factors as possible. This can be difficult for many who struggle with their own bias or who may not fully investigate or understand their client’s background.

Luckily, there are many tools that help you assess risk.  Depending on your role, setting and resources, there is likely a tool designed specifically for your situation. Likewise, raw data can be an indicator of risk.  For instance, a child who is chronically absent, frequently complains of stomach aches or is often lethargic is displaying symptoms of many serious issues. Once you have identified these risk factors you should be able to connect some of the cause and then link some of the outcomes you wish to prevent.  But how do you do that?

First, if you are providing support, you must earn trust.  Very frequently those in our society who are at the highest level of risk have been neglected, ignored or even betrayed by the very supports that were designed to help them.  A provider of support must meet the person where they are at.  This means we can’t expect someone who needs help to ask for help nor come to us to receive that help.  The methodology surrounding care is quite extensive, but basically you must be consistent, provide a safe (physically and mentally) environment, show empathy, respect and encourage participation in the programs. Often, this requires providing for basic needs such as food, housing or healthcare before you can expect someone to engage in more complicated services such as therapy, in-home tutoring, support groups, etc.

When you are thinking about risk factors, you must also consider some of the strengths a client has.  These could be their family, community, talent or other connection.  While focusing on their deficits, weave in these strengths that can form natural supports.  Every person is different, and not all approaches will work for each person, so you must have tailored interventions for each person that considers their risks, deficits and strengths.

An initial intervention or supportive measure can be singular, but each plan must be multifaceted.  At Lincoln Prairie we realize that the same approach will not work for every kid, that is why we have art therapy, music therapy, equine therapy, recreational therapy as well as utilizing traditional forms of therapy like CBT and DBT.

In conclusion, I ask that you continue to consider and reevaluate what puts a person with whom you interact at risk. If you try to put yourself in their situation, you may be able to develop an empathic guideline that will help reveal factors of risk.  Whether this is a patient, co-worker, colleague, family member or client, imagining yourself in their role can be an insightful way to recognize their risk factors.

Lincoln Prairie Behavioral Health Center provides inpatient and outpatient behavioral health services for children and adolescents in Springfield, Illinois. The programs are designed to address the emotional, social and behavioral needs of people experiencing difficulties across home, social and community settings.

To learn more about our equine therapy services, contact us online or give us a call at 217-585-1180.