Mental health practice: a risky business?
| Pages | 1-2 |
| DOI | https://doi.org/10.1108/JMHTEP-11-2017-0061 |
| Published date | 08 January 2018 |
| Date | 08 January 2018 |
| Author | Anne Felton,Nicola Wright |
| Subject Matter | Health & social care,Mental health,Mental health education |
Anne Felton and Nicola Wright
Mental health practice: a risky business?
Risk is a core aspect of mental health practice that remains high on the agenda for mental health
services and professionals. However, the growth of the recovery philosophy in mental care has
raised new questions about the impact of risk assessment and management approaches,
creating the need for a critical debate surrounding risk. This special edition draws on a wide
range of expertise to examine theoretical, professional and service user perspectives on risk and
mental health. It aims to promote recovery-orientated practice through critique and the
exploration of new ways of working with risk.
Until recently, the majority of literature on risk and mental health focussed on the evidence base
of risk calculation with debates centred on the validity of clinical judgements and risk assessment
tools. More recently, a small but growing voice has demanded the need to recognise the
limitations of these approaches to understanding risk. There has been increased recognition of
the damaging impact the process of risk assessment and the consequences, often in terms of
restrictive practices can have on service users. The publication of Boardmen and Roberts (2014)
“Risk, safety and recovery”paper for Implementing Recovery Through Organisational Change
set out the key challenges for mental health services to adopt ways of working with risk that
promote rather than undermine the principles of recovery. A shift in practice involves
acknowledging the expertise of lived experience and the importance of people with mental health
problems having access to opportunities through positive risk taking and collaborative
approaches to safety planning. Risk can dominate service users’identity and adopting these
approaches has the potential to challenge the influence of risk in peoples’lives (Felton, 2015).
However, professionals remain under pressure to provide accurate predictions of future events
and satisfy organisational demands.
The special edition draws together international work of practitioners, academics and service
users to first offer a critical examination of risk in the context of mental health services before
considering the role of recovery and the adoption of more person-centred approaches to
promoting safety and managing risk.
The edition begins with two papers which examine the current risk assessment and
management practices with a particular focus on the areas of violence and aggression. These
issues have often presented the biggest challenge to policy makers, the media and the public
and have been influential in both practice and the literature on risk. Callaghan and Grundy
present a narrative review of risk assessment of violence and mental health from both an
evidence and conceptual perspective. The paper highlights that risk assessments aspire to
reduce harm yet have little impact on this area whilst actually perpetuating stigma against people
with mental health problems. The paper sets out a powerful starting position to question
contemporary practice of risk assessment.
The second article offers in-depth insight into the viewpoint of practicing Psychiatrist Giles
Newton-Howes. Echoing the previous paper’s recognition of the limitations of risk assessment,
this article explores the societal and legal influences on risk-orientated practice for mental health
professionals. The stimulating discussion concludes with the need to move away from the
practices focussed on prediction of risk to collaborative recovery-orientated relationships with
service users and their families to facilitate not only safety but high-quality care.
The remaining four papers consider risk and recovery, incorporating an exploration of
professionals’perspectives, older peoples’views and theoretical inquiry. Crowe and Deane offer
an empirical analysis of implementing positive risk taking which involved investigating the
Anne Felton is an Associate
Professor at the School of
Health Sciences, University of
Nottingham, Nottingham, UK.
Nicola Wright is a Lecturer in
Mental Health at the School of
Health Sciences, University of
Nottingham, Nottingham, UK.
DOI 10.1108/JMHTEP-11-2017-0061 VOL. 13 NO. 1 2018, pp.1-2, © Emerald Publishing Limited, ISSN 1755-6228
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THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
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