Mental Health Workers Negotiating Risk on the Frontline

Sawyer, Anne-Maree

doi:10.1080/03124070903265724

Cited by 24 publications

(23 citation statements)

References 19 publications

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“…Thus, responsibility can be emphasised above other recovery principles of client agency and empowerment. Some workers linked this to managerial, neoliberal agendas concerned with reducing the costs of providing more intensive services, as have some commentators in the literature (Ramon et al, 2007;Sawyer, 2009). For example, Danielle said that recovery is used ''as a tool to avoid some sort of responsibility in terms of service provision'', whereas Carol suggested that recovery could be ''misused as a cost saving idea''.…”

Section: Professional Resistance and Managerial Agendasmentioning

confidence: 94%

“…This is in part attributable to the fact that community mental health services are increasingly responsible for providing community-based treatment to clients with serious and enduring mental illness who would have been treated as inpatients in the past (Brophy & McDermott, 2003;Chesters, 2005;Sawyer, 2008Sawyer, , 2009), leading to a preoccupation with risk management and security (Brophy & Healy, 2009;Sawyer, 2008). In Australia, this growing concern with risk management has spawned an increase in community involuntary treatment orders (CTOs) (Brophy & Healy, 2009;Brophy & McDermott, 2003), also referred to as community care orders, community management orders, and involuntary treatment orders.…”

Section: The Rise Of the Recovery Model And Risk Managementmentioning

confidence: 98%

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Beyond Balancing Competing Needs: Embedding Involuntary Treatment Within a Recovery Approach to Mental Health Social Work

Courtney

Moulding

2013

Australian Social Work

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The recovery model of mental illness has become increasingly influential over the past two decades and while the synergies with social work are strong, there has been no examination of how social workers manage working within a recovery framework with involuntary clients in risk management-oriented settings. In this paper we report on a qualitative study with 10 mental health social workers exploring how such tensions are managed in everyday practice. While the social workers identified numerous dilemmas, they drew on a combination of recovery principles and social work values and practice approaches in an effort to move client agency closer to the centre of multidisciplinary interventions. We conclude that while the implementation of a recovery approach in the Australian mental health system has been at best uneven, its official embrace lends social workers a sense of legitimacy in advocating for client rights in the complicating context of involuntary community treatment.

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Section: Professional Resistance and Managerial Agendasmentioning

confidence: 94%

Section: The Rise Of the Recovery Model And Risk Managementmentioning

confidence: 98%

Beyond Balancing Competing Needs: Embedding Involuntary Treatment Within a Recovery Approach to Mental Health Social Work

Courtney

Moulding

2013

Australian Social Work

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“…For example, some peers might be involuntarily admitted into hospital. As clinical services have become more orientated to the assessment and management of risk, mental health clinicians seem to have increasingly limited opportunities to develop therapeutic relationships with their clients (Sawyer, 2005(Sawyer, , 2008(Sawyer, , 2009). In some cases, peers could feel betrayed when their peer supporters contacted clinical services on their behalf (Rose, peer supporter).…”

Section: H S R H S R H S R H S Rmentioning

confidence: 99%

“…The practices this change generates are particularly directed towards liminal 'others' who are socially excluded, such as mental health service users. In mental health practice risk management is now placed at the forefront of everyday consciousness and activities (Godin 2004;Kelly 2000;Langan 2010;Rose 1998;Sawyer 2005Sawyer , 2008Sawyer , 2009. In relation to this focus on The term 'peer' is often used by peer supporters to refer to members of their client group.…”

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confidence: 99%

‘Having those conversations’: The politics of risk in peer support practice

Scott

Doughty

Kahi

2011

Health Sociology Review

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“… diverts resources towards those who are considered to be of high or future risk rather than providing resources to the majority or those considered to have high needs (Mullen, 2001;Sheehan et al, 2010);  claims to be morally neutral but is viewed as generating stigmatising, defensive and blaming cultures across human service agencies (Coffey, 2012;Fenton, 2013;Kemshall, 2002;Sawyer, 2009;Stanford, 2010Stanford, , 2011.…”

Section: Policy/organisation Risk Environmentmentioning

confidence: 99%

Hoping Against Hope: The Prison-to-Community Transition Experience of Men With Co-Occurring Severe Mental Illness and Substance Use Disorder

Denton¹

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This thesis explores the prison-to-community transition experience after short-term incarceration, from the perspective of men with co-occurring mental illness and substance use disorder in Queensland, Australia. A specific focus was to examine the impact of systems and structures on the individual experience of transition. Prior research has established that people with co-occurring mental illness and substance use are overrepresented in the Australian prisoner population. It is also known that transition from prison to community for the general custodial population is a time of vulnerability, with increased risk of substance use, homelessness, unemployment, reincarceration and post-release death. All of these risks are compounded for prisoners with co-occurring disorders who are also at risk of a range of poor criminal justice outcomes and losing contact with mental health services after release.Review of the literature indicates a tendency for research to focus on recidivism as an outcome and emphasise either individual risk behaviour or social and structural factors influencing prison-to-community transition. Interventions during transition for the current population have traditionally been based on the criminalisation hypothesis, with a focus on increased provision of mental health services in prison and an emphasis on continuity of care in the community. There is a growing recognition in the international literature that the issues are much broader than mental illness; however, there is a lack of clarity as to how to respond to the complex needs of this population. Research exploring the perspective of men with cooccurring severe mental illness and substance use disorder during their prison-to-community transition experience has rarely been undertaken.The conceptual framework developed for this study shifts the emphasis away from recidivism towards recovery and wellbeing through a lens of individual action, but only in the context of the potential for systems and structures to impact on the ability of individuals to exercise agency. A qualitative method was used comprising repeat in-depth interviews with 18 men: within 1 month prior to leaving prison, within 2 weeks post-release and at 3 months postrelease. Three themes characterised the transition experience of participants: "hoping against hope"; "adrift in freedom"; and "the slippery slope". Participants reported leaving the predictable and routine life in prison where they hoped for a better life after release, to an uncertain, unstable and isolated environment in the community, eventually sliding into drug use, chaos and despair. The risk environment framework (Rhodes, 2009) and structuration theory (Giddens, 1984) were employed to understand how participants were caught in a complex dynamic between their individual risk behaviour and broader structural risk iii environments. This thesis proposes that a web of interrelated factors contributed to participants in the study as "ambivalent agents" who were suspended between the two worlds of priso...

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Mental Health Workers Negotiating Risk on the Frontline

Cited by 24 publications

References 19 publications

Beyond Balancing Competing Needs: Embedding Involuntary Treatment Within a Recovery Approach to Mental Health Social Work

Beyond Balancing Competing Needs: Embedding Involuntary Treatment Within a Recovery Approach to Mental Health Social Work

‘Having those conversations’: The politics of risk in peer support practice

Hoping Against Hope: The Prison-to-Community Transition Experience of Men With Co-Occurring Severe Mental Illness and Substance Use Disorder

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