Community care has increased the focus on risk management, and mental health nurses increasingly find themselves being pulled in two directions. Can they manage to promote a service user’s liberty, while simultaneously endeavouring to protect the individual and society from danger? Theodore Stickley and Anne Felton explore the tensions surrounding the risk assessment process

Historically, there has been a long association between ‘mental disorder’ and risk. With the advancement of community care, and more latterly through the implementation of the National Service Framework for Mental Health (NSF) (DH 1999), mental health service providers are required to manage more carefully than ever the risk of those who receive their services. While there has been a focus on risk assessment and risk management of those who have ongoing mental health problems, there is a dearth of literature that promotes therapeutic risk taking, or what may be referred to as positive risk taking. In this article, we consider the notion of therapeutic risk taking and its significance in promoting recovery. Mental health nurses have a responsibility to promote the individual’s right to freedom while at the same time promote society’s right to be protected from danger. We consider the tension that exists in contemporary mental health policy and practice that on the one hand promotes freedom and choice and on the other, appears to endorse control, and how this affects nurses (Barker 2000).