This chapter focuses on the contradictions created by therapeutic optimism in the countervailing context of a ‘risk society’ (Beck, 1992). Once mental disorder is designated as a medical condition, like any other, then efforts at facilitating help could be framed like aiding a patient’s recovery from a broken arm. However, this position disavows the role played by mental health professions: they are agents of the State, with particular legal powers to remove liberty without trial and to manage risk to others, not just patients themselves. As the quote above suggests, from the perspective of the State, treatment may need to happen with or without the consent of the ‘disordered’. The whole question about risk management in mental health services will be discussed in this chapter in order to problematise the assumption of therapeutic optimism and its expression now in the dominant provider-preferred notion of ‘recovery’. As we discussed in Chapter 2, what we mean by ‘therapeutic optimism’ is a belief in the efficacy of treatments, services, supports and systems of care to effect change for individuals with a diagnosis of mental disorder.
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