Recovery versus risk? From managing risk to the co-production of safety and opportunity
| Published date | 09 May 2016 |
| Date | 09 May 2016 |
| DOI | https://doi.org/10.1108/MHSI-08-2015-0029 |
| Pages | 101-109 |
| Author | Rachel Perkins,Julie Repper |
| Subject Matter | Health & social care,Mental health,Social inclusion |
Recovery versus risk? From managing
risk to the co-production of safety and
opportunity
Rachel Perkins and Julie Repper
Rachel Perkins is based at
ImROC, London, UK.
Julie Repper is Recovery Lead
at Nottinghamshire Healthcare
Trust, Nottingham, UK.
Abstract
Purpose –The purpose of this paper is to propose a recovery-focusedapproach to risk and safety and what
this might look like in practice.
Design/methodology/approach –Review of recovery approaches and the ways in which traditional
approaches to risk might hinder people in their recovery journey. Consideration of the principles of a
recovery-focused approach to safety.
Findings –A recovery-focused approach to risk based on co-produced safety plans that enable people to
do the things they value as safely as possible and shared responsibility for safety. Four key principles of a
recovery-focused approach to promoting safety, autonomy and opportunity are proposed.
Originality/value –A recovery-focused approach to risk and safety is central to the development of
recovery-focused practice within services. This paper outlines such an approach.
Keywords Recovery, Risk assessment and management, Safety planning, Shared decision making
Paper type Conceptual paper
Policy and practice in mental health services prioritise both the promotion of recovery and the
minimisation of risk (Department of Health, 2011). Often these appear mutually incompatible: it is
assumed that those things that are important to promoting recovery result in increased risk.
Recovery focuses on strengths and personal resources and is about rebuilding your life and
exploring your possibilities; self-control and self-determination; taking back control over your life,
destiny and the treatment/support you receive to deal with challenges you face. Traditional
approaches to risk assessment and management focus on problems, deficits and dysfunctions
and are about professionals taking control and managing risk; avoiding danger by stopping
people doing things that are considered risky (see Table I).
There has been much discussion about the balance between risk and self-determination in the
context of “positive”or “therapeutic”risk taking (Morgan, 2000). Professionals, people using
services and the mental health act commission have all voiced concerns about the way in which
a pre-occupation with risks is detrimental (Morgan, 2007; Royal College of Psychiatrists, 2008,
2010; Coleman, 2011; Care Services Improvement Partnership/Department of Health, 2006;
Mental Health Act Commission, 2009). Yet many mental health workers continue to feel pulled by
opposing forces (Felton and Stacey, 2008) and in practice managing risk takes precedence over
promoting autonomy (Pilgrim, 2007). Safety is important, but a wholly risk averse culture denies
countless people the opportunity to discover and pursue their possibilities. The development of a
recovery-focused approach to risk and safety lies at the heart of the development of recovery-
focused practice: “could transform mental health services and unlock the potential of thousands”
(Future Vision Coalition, 2009).
DOI 10.1108/MHSI-08-2015-0029 VOL. 20 NO. 2 2016, pp. 101-109, © Emerald Group Publishing Limited, ISSN 2042-8308
j
MENTALHEALTH AND SOCIAL INCLUSION
j
PAG E 10 1
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