From the 1980s onwards discourses of risk have continued to grow, almost in ubiquity. Ideas and practices of risk and risk aversion have extended to UK mental health care where services are expected to assess and manage risks, and high quality clinical assessment has been revised to incorporate risk assessment. This article problematises practices of risk assessment in mental health provision, focusing on the base rate problem. It presents an analysis of audio recordings of risk assessments completed within a primary care mental health service. The analysis is informed by a critical logics approach which, using ideas from discourse theory as well as Lacanian psychoanalysis, involves developing a set of logics to describe, analyse and explain social phenomena. We characterise the assessments as functioning according to social logics of well-oiled administration and preservation, whereby bureaucratic processes are prioritised, contingency ironed out or ignored and a need to manage potential risks to the service are the dominant operational frames. These logics are considered in terms of their beatific and horrific fantasmatic dimensions, whereby risk assessment is enacted as infallible (beatific) until clients become threats (horrific), creating a range of potential false negatives, false positives and so forth. These processes function to obscure or background problems with risk assessment, by generating practices that favour and offer protection to assessors, at the expense of those being assessed, thus presenting a challenge to the stated aim of risk assessment practice.

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This study explores contemporary treatments of depression in relation to Michel Foucault’s disciplinary techniques. These techniques are used as analytical tools and applied to two current treatments of depression: guided self-help and cognitive behavioural therapy. The analysis shows that in many ways these treatments do align with, and thus can be considered, disciplinary techniques. This increases the importance of considering issues of politics and power in relation to how people with depression are treated. However, this does not tell the full story; looking solely at disciplinary techniques does not capture the complexity of today’s treatments of depression. In attempting to adopt a conceptual approach that can speak to and complement clinical work, the notion of multiplicity is discussed as a way of retaining the important insights of Foucault’s work but also attending to the specific clinical practices that make depression what it is today.