City Research Online

Playing the game: service users' management of risk status in a UK medium secure forensic mental health service

Reynolds, L. M., Jones, J. C., Davies, J. , Freeth, D. & Heyman, B. (2014). Playing the game: service users' management of risk status in a UK medium secure forensic mental health service. Health, Risk and Society, 16(3), pp. 199-209. doi: 10.1080/13698575.2014.911820


In this article we examine how forensic mental health service users actively attempt to manage their risk status through playing the game of containing frustration and demonstrating compliance. The article draws on an observational study (2006 to 2009) which explored the practices of risk assessment and management within one inner city forensic mental health medium secure service in the UK. We used a grounded theory approach to explore service users and providers experiences of risk assessment and management. We interviewed forensic mental health service users and providers. We also collected data using participant and non-participant observation. Since access to forensic mental health services is tightly controlled, there are participant observation studies undertaken in these settings.

We found that service users attempted to understand the system of assessment and sought to affect and reduce their risk status by engaging in overt, compliant behaviours. We argue that in doing so service users are active agents in the process of risk management. However, we indicate that there are adverse effects of this approach to risk management as the risk assessment process is subverted by the restriction of the flow of information, and service users are left with frustrations that they must contain and manage.

Publication Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis Group in Health Risk and Society on 04/02/2014, available online at:,
Publisher Keywords: risk assessment, risk management, forensic mental health, service user involvement
Subjects: R Medicine > RA Public aspects of medicine
Departments: School of Health & Psychological Sciences > Nursing
Download (340kB) | Preview



Downloads per month over past year

View more statistics

Actions (login required)

Admin Login Admin Login