title: New risks: the intended and unintended effects of mental health reform.
abstract: In crisis situations, the authority of the nurse is legitimised by legal powers and professional knowledge. Crisis stakeholders include those who directly use services and their families, and a wide range of health, social service and justice agencies. Alternative strategies such as therapeutic risk taking from the perspective of socially inclusive recovery policy coexist in a sometimes uneasy relationship with mental health legislation. A critical discourse analysis was undertaken to examine mental health policies and guidelines, and we interviewed service users, families, nurses and the police about experiences of accessing services. For those who attempt to access services early in crisis, as is suggested to lead to a better outcome, provision of services and rights appear to be reversed by an attempt to exclude them through practices that screen them out, rather than prioritising a choice in access.
authors: Massey University, Palmerston North, New Zealand.
authors: Stacey C
authors: SC
authors: Wilson
authors: Massey University, Palmerston North, New Zealand.
authors: Jenny
authors: J
authors: Carryer
authors: University of Southampton, Southampton, UK.
authors: Tula
authors: T
authors: Brannelly
mesh_terms: D003419:Crisis Intervention / Q000379:methods*; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D006291:Health Policy; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy; D008605:Mental Health Services / Q000600:supply & distribution*; D028642:Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000523:psychology; D009726:Nurses; D011582:Psychological Theory; D018570:Risk Assessment
keywords: Foucault; critical theory; discourse; health reform; mental health