The relationship between risk, mental health and recovery is complex. When we think of risk we tend to concentrate on the negative aspects of risk – we think of the things that could go wrong.

The reality is that risk is a two way process and when it comes to supporting recovery we also need to be aware of the risks of not trying out things and not taking chances. This aspect of risk is sometimes described as positive risk taking and it can be an important part of growth and recovery.

Service providing organisations are interested in the more negative aspects of risk. While this has the potential to lead to risk averse cultures and services, they do need to manage risk responsibly, particularly when people using their services are at their most unwell and could be a risk to themselves and other people.

When considering risk we should be aware of the following:

• Risk has positive and negative aspects.
• Sharing decisions and being clear on decisions means risks are shared both within teams and with the person using the service.
• Different practitioners and professions can have different levels of tolerance to risk.This could be related to their responsibilities or their practice or values.

Working with risk in peer support relationships

Risk is about much more than managing or preventing things from going wrong. Positive risk taking is an important element of recovery because it provides an opportunity to move forward. This could mean stepping out of our comfort zone and trying new things.

After all, we must recognise that risk-taking is an inherent part of all our lives. People with lived experience of mental health problems have to take positive risks to move on in their recovery and you will have had to take some risks to get onto and through this course.

While it might seem obvious that taking certain risks helps us to grow, it can feel more uncomfortable when the people we are supporting start to try new things. We may be aware that their previous attempts didn’t work out, or you could have tried what it is they are suggesting and it didn’t work out for you.

Sometimes this gets confusing. We want people to be supported in making new choices. But when we see their choices as potential hazards we can find ourselves trying to convince them to either not do what they want, or to do it differently. This is motivated by our own discomfort.

Because of our position of power, we can find ourselves being rather coercive, and this is not where we should be going as part of a productive peer support relationship.

Risks and ethics

All types of service provision and professional groups tend to be underpinned by ethical codes or statements. Ethical statements basically tell us how we should act in any given situation. They usually have moral assumptions embedded in them.

Statements of professional ethics are inseparable from personal beliefs in the sense that individuals either agree with them or not. The debates around mental health provision and practice can be controversial. One example is the medicalisation of the majority of mental health issues versus the notion of a peer support relationship that works with individuals to support them to find their own voyage of recovery.

In ethical dilemmas there is usually no clear or easy answer to many of the complex questions in relation to mental health. This is due, in part, to the fact that mental health care takes place in a problematic environment where issues and questions constantly arise, and cannot necessarily be ‘solved’.