Abstract

SummaryThere is an inexorable drive in psychiatric services in the UK, including forensic services, towards organising and delivering care based on the principles of the recovery model. Hence recovery, and its subjective and objective measures, is the goal of these services and the standard by which the quality of the service is evaluated. At the same time, all psychiatric services are expected to practise evidence-based risk assessment and management practices and can be subject to severe criticism or sanctions if they do not do so. In this paper I set out the view that the values that underlie the recovery approach and the clinical risk assessment approach appear to be polar opposites. However, an understanding of human behaviour using a humanneeds model is an explanatory paradigm that underlies both the recovery model and the understanding of risk behaviour, and can thus unify these two approaches. Therefore a more explicit integration of this model into forensic care would be beneficial and there should be more research directed to the correlates of recovery-oriented measures and risk-related measures.

Highlights

  • It is a moot point that psychiatric services in the UK, including forensic services, should have as its main objective assisting the individual service user to ‘recover’ from mental disorder.[1]

  • Several recent publications from all professional disciplines, such as From Values to Action: the CNOs Review of Mental Health Nursing from the Department of Health in 20063 and the joint publication from the Royal College of Psychiatrists and the Social Care Institute for Excellence entitled A Common Purpose: Recovery in Future Mental Health Services in 20074 have led the drive to ensure that services are organised and delivered at all levels based on recovery principles

  • Alongside the issues discussed above, there is an expectation of all psychiatric services, in particular forensic services, that they effectively assess and manage the risks that a service user poses to themselves and others

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Summary

SPECIAL ARTICLE

Summary There is an inexorable drive in psychiatric services in the UK, including forensic services, towards organising and delivering care based on the principles of the recovery model. It is a moot point that psychiatric services in the UK, including forensic services, should have as its main (if ) objective assisting the individual service user to ‘recover’ from mental disorder.[1] The term ‘assist’ in recovery is used to align services with a commonly accepted definition of recovery, provided by Anthony who stated that ‘recovery is a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and roles It is a way of living a satisfying, hopeful and contributing life, even with the limitations caused by illness.

What is recovery and what values drive it?
What are the values underlying risk assessment?
The human needs model of motivation and behaviour
The need for growth and development
Needs assessment does not replace formulation
What is the purpose of rehabilitation?
Findings
Conclusions
Full Text
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