The Constructions of Risk by Mental Health Professionals Working in a Low and Medium Secure Forensic Service

This study adopts a Foucauldian Discourse Analysis (FDA) on the subject of how mental health professionals working in low and medium secure forensic services construct the meaning of risk.
A critical review of the literature illustrates the emergence of the concept of risk and the diversity in which it is constructed including the proliferation of risk assessment tools in an attempt to quantify the phenomenon. In contrast, the aim of this study was to focus on the meaning of the concept by exploring how ten mental health professionals make sense of and construct risk while adopting an epistemological position of critical realism with social constructionism. Such an approach enabled an exploration of broader social and contextual factors influencing the constructed nature of the concept and the implications for their clinical practice.
Three interconnecting discursive sites were formed in the analysis of this research. These were termed: ‘Constructing the system as an inhibitor to meaningful information about patients and risk’, ‘The construction of risk to professionals through surveillance and accountability’ and ‘The construction of risk in relation to responsibility and as something that can be transferred’.
Implications for clinical practice suggested by the analysis included the role of supervision and reflexivity, the short-term toleration of immediate risk by services, the role of forensic service policy in relation to the recovery agenda, and the suggestion of counter-inquiries alongside the current practice of homicide inquiries.