Risk thinking and the priorities of mental health social work organizations

This chapter examines how risk thinking and practices, shaped by new managerialism and neoliberal economic policies and situated in context of austerity cuts in public spending, have come to dominate the priorities of mental health social work organizations in England. Risk for the organization has become framed not just as clinical risk posed by service users but financial and performance risk within a service delivery business model. We argue that therapeutic intervention has been marginalized and risk management dominates what remains of the therapeutic focus. Practitioners are diverted from direct work with service users by the demands of bureaucratic procedures, and yet the potential consequences of clinical or performance failure are severe. The chapter draws on the direct management experience of the first two authors, and on psychodynamic insights to explore how frontline practice exposes the operations of risk thinking within mental health services and to reflect on the dilemmas of working within the risk paradigm.