Risk assessments for mental health service users: ethical, valid and reliable?

Summary: This article considers the nature and basis of risk assessments in mental health services, based on empirical research on the tools used within NHS Mental Health Trusts in England which found a wide variety of such tools in use within them. Findings: The article examines the problems and potential benefits in the use of such tools, and argues for an inclusive and holistic approach to risk assessments which incorporate our knowledge of the risks of risk assessments. The article pays particular attention to risk assessment procedures as relevant to social workers who have to uphold the requirements of the General Social Care Council Code of Practice, which provides particular emphasis on issues of risk, and service user and carer involvement in assessments. Potential biases and limitations of risk assessment approaches, it is proposed, need to be taken into account in order to have a balanced view of the value of such approaches. Applications: The article provides a critique of the validity and effectiveness of current risk assessment tools, focusing in upon one key area in mental health work, the assessment and management of potential violence.