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. 2025 Jul;32(3):e70032.
doi: 10.1111/nin.70032.

Managing the Unpredictable - Discourses of Power and Knowledge in Mental Health Risk Management

Marion C A Bakke  1 , Frans Fluttert  1   2   3 , Truls I Juritzen  4
Affiliations

Managing the Unpredictable - Discourses of Power and Knowledge in Mental Health Risk Management

Marion C A Bakke et al. Nurs Inq. 2025 Jul.

Abstract

In mental health, the safety and risk concept refers to a complex phenomenon with strong connections to risk management strategies, simultaneously influenced by the ideals of patient involvement and empowerment. The aim of this paper is to analyze discourses linked to patient involvement and the management of risk and safety, as articulated in the protocol for the Early Recognition Method (ERM) risk management strategy. As an analytical tool, we have drawn inspiration from the discourse theory of Michel Foucault and utilized Hall's six elements for discourse analysis. Our analysis indicates that the ERM protocol rests its discursive authority upon two main discourses: one, a scientific medical discourse and the other, a discourse strongly linked to empowerment and patient involvement. These two discourses are interrelated in a complex fluctuation of power dynamics in which they sometimes complement each other and, at other times, are in conflict. We claim that by applying a Foucauldian angle on discourse, power, and knowledge, our analysis may facilitate a critical awareness of the power dynamics inherent in risk management discourses and provide valuable insights into how articulations of safety and risk - combined with ideals of participation and empowerment - contribute to reframing practices in mental health care.

Keywords: aggression; discourse; early warning signs; mental health; power relations; risk management; safety; violence.

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Conflict of interest statement

The authors declare no conflicts of interest.

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