Psychiatry: a risky business?

Extract

Following a series of well-publicised tragedies the Department of Health published guidelines on the discharge and aftercare of psychiatric patients (Department of Health, 1994). These guidelines stipulate that at the time of discharge from in-patient care the treatment team will have carried out a risk assessment, with the expectation that professionals will be criticised if things go wrong. Risk assessment is now a routine, if poorly understood, element of clinical practice. The allied concept of risk management, which lacks a simple definition but is “aimed at reducing the likelihood of harming patients during treatment, minimising trauma to those who are affected, and controlling the possibility of subsequent litigation” (Vincent, 1995), is much less familiar to clinicians. The Editor has commissioned a short series of articles that address the topic of risk in psychiatry, covering suicide, dangerousness, the exposed role of Mental Health Review Tribunals in the case of Restricted patients and a variety of professional risks. The aim is not to be didactic but to raise the level of debate about the risky business that psychiatrists are engaged in.