The Construction of people with mental health problems as risk objects: findings of a case study inquiry [2018]

The emergence of recovery, alongside significant focus on risk management, creates potential for conflicting influences in mental health care. Although evidence has critiqued risk assessment, there is a lack of research that seeks to explore how professionals make decisions within these apparently incompatible agendas.

To explore how practitioners, experience potential tensions arising from delivering recovery‐orientated care and enforcing containment.

This paper reports on a case study inquiry, using interviews with mental health professionals and observations in an acute ward and an assertive outreach team.

Risk governed the practice of mental health professionals to such an extent it defined how service users were understood and treated. Service users were constructed as objects of risk, first by being objectified and secondly by creating a link between that object and harm.

Hilgartner’s (1992) theory of risk explains how risk dominates the identity of people with mental health problems at the cost of recovery. This results in increased monitoring, surveillance and medication to enact control.

Implications for Practice
To undermine the dominance of risk, professionals should reconnect with the subjective experiences of people with mental health problems and challenge the acceptance of risk as central to their role.

Anne Felton, Julie Repper, Mark Avis

Journal of Psychiatric and Mental Health Nursing, 29 October 2018