ABSTRACT
Neil Foster is a community mental health manager in the UK and also an Approved social worker (ASW) under the Mental Health Act (1983). In the UK the approved social worker has a pivotal role in conjunction with medical professionals in the application of powers of compulsory admission to hospital. In this chapter Neil seeks to examine some of the mechanisms available to professionals in managing mental health risks in the community in three societies which exhibit a preoccupation with risk from professional and organisational points of view and where specific forms of legal control have evolved to secure compliance and satisfy growing public and political concerns. A comparative approach is adopted by using a case study/scenario which highlights how the law and service entitlements may interact in practice as events unfold, and how professional practices which enhance or inhibit citizenship entitlements are located within contrasting legal frameworks. In recent years in all three societies there has been a noticeable convergence of service forms and configurations in response to neoliberal economic and welfare reforms, the political dominance of ‘risk aversive’ agendas, the challenges of de-institutionalisation and the increasing professional and managerial focus on what does and what does not work in community mental health. Rarely is ‘best evidence’ easily uncovered in this field, neither is it unproblematic to assume that consensus is easily reached as to what would constitute an improved state of affairs for all stakeholders, whose interests and perceptions often differ widely. Service users, carers, neighbours and local community interests, hospital managers, different professions with their distinct yet complementary knowledge bases, police authorities, politicians and academics all offer observations and insights. The territory is vigorously contested. In the midst of this melee the mental health professional is increasingly subject to more rigorous forms of bureaucratic surveillance, ever wary and arguably much less inclined toward therapeutic risk-taking.
