Risk and protection: the discourse of confinement in contemporary mental health policy

Abstract

Confinement has regained respectability in the discourses of contemporary UK mental health policy. This development reflects concern about violent offences by people with mental health problems and is rooted in claims about the ‘failure’ of community care. Confinement is presented as a strategic response to the risks and dangers posed by particular fractions of the population of mental health service users. Using two key policy statements issued by the Department of Health and associated discussions in the health services management press, the confinement theme is explored and assessed. The paper notes its emergence as a consequence of the spatial impacts of deinstitutionalisation and its specific origins in response to violent offences by people with mental health problems. The notion that the growing emphasis on confinement presages a return to the asylum is considered and rejected. Rather, the paper stresses the importance of discourses of protection, safety, risk and dangerousness in understanding the turn to confinement.