Risk in Mental Health

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In what ways does the concept of risk in mental health policy and practice represent a problem for mental health service users/ survivors. With the closing of the large intuitions in the early 1990s and the rise of smaller units being set up within communities, the policy change ideology was for individuals who have a mental illness to live independent lives, and to learn skills to function within society. It was deemed that these vulnerable individual’s faced more risk from staff than what small risk they posed to others. ( k272, Reader, p.138). However if there was a need for intervention then there would be the power to detain that person against their wishes in hospital to ensure their safety and that of others. The Mental Health Act (1983) is the piece of statute law in the United Kingdom which allows this. This act is reviewed and regulated by the Mental Health Act Commission (MHAC). With this change in policy, there has been panic due to perceived risks which are faced by the public from individuals whom suffer mental distress. This has been reinforced by the media. (K272, Unit 14, p.40). These fears which the Public share are firstly exaggerated and are inaccurate with respect to the correlation between mental illness and violence. ( K272, unit 14, p.38, Start et al, 2004, ). Research has shown that self - harm and suicidal risk is much greater, than that of violence to the public, even though the media represents, it differently. (Mind, 2006). Today risk management has become central to practice in Mental Health services. ( K272, Unit 14, p.13). The concept of risk is a difficult starting point has it can have different meaning to people and depends on its usage and content. ( K272, Unit 14, p.34). This has resulted in difference in services received. When the Care Programme Approach ( CPA), within England was set up there was no focus on risk. ( DOH, 1990). Now in mental health services there are two types of risk assessments which are undertaken: firstly are actuarial, this is based on statists that display information of ‘high - risk groups’. ( k272, unit 14,p.35). The second is clinical risk assessments, where the professional uses their prior knowledge to assess the outcome, and the risks involved. When completing a risk assessment both types are often combined. Risk assessments therefore are never completely accurate; with the solution of a ‘better safe than sorry’ approach to mental health policy which is ethnically and pragmatically flawed. ( k272 Reader, p.140). One could argue that in fact now service users are now often referred to by the risks they present as opposed to the needs which they require. Has mental health policy has moved further in trying to control individuals whom suffer mental distress, it may not take into account the person’s strengths. Therefore this can result in service users not being empowered to gain new skills or the chance to make changes in their lives.(k272, Reader, .40). Guidance states that service users should be involved in the process of risk assessment and risk management. ( DOH, 1999). In reality there is little guidance on how to achieve this apart from the assessment should take account of all aspects of a person’s life. ( DOH, 1999). Most government guidance high lights that most people whom suffer with mental distress pose no risk, but acknowledge that there is a small section of individuals who do. ( k272, unit 14, p.39). In 1998 the government stated that ‘care in the community has failed’. ( k272, Unit 14, p 39). The reason was due to risks, such as violence which were faced to the public. ( k272, Unit 14, p.39). This statement has surged more negative media reports and reinforced the public’s fear, this in turn has led to more prejudice and discrimination. With increasing media reports this then has power to influence policy makers to help calm pressure from public. (k272, Reader, p. 139). The charity Mind carried out a survey where it asked service...
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