There has long been a concern with risk assessments in mental health care. Such assessments are notoriously difficult and prediction of risky behaviours, particularly towards others, nearly impossible. Use of actuarial tools is consequently discouraged with the individual service user and their circumstances now being the focus of attention. The issue of risk assessment is part of the longstanding debate about care versus control in mental health services as risk is now the central plank in considering detention and compulsion.

A further issue that has received attention is that of ‘positive risk taking’. There is a contradiction between the stated ideal of health service users being involved and in control of their care and the existence, in mental health uniquely, of legislation which can take away any control at all.

Care planning and coordination includes assessment and management of risk and safety. Methods

This paper is a sub-study of a larger piece of work on care planning which used a mixed methods approach (the COCAPP study published earlier this year, which was covered on the Mental Elf).