Safety and Security: A Delicate Balance

Safety and security are essential concepts for everyone involved in mental health care. Safety means the absence of potential harm, while security refers to the protection against deliberate, external threats. The focus on the management of safety and security changes from Safety-I (avoiding that something goes wrong) to Safety-II (ensuring that everything goes right). Due to societal dilemmas, clinical practice needs to address safety and security for everyone involved in mental services, instead of primarily safety and security of professionals. The primary focus of safety management should be on relational safety and security, instead of procedural and environmental safety and security. Several organisational innovations, such as High Intensive Care, Six Core Strategies, and Safewards, assist in ensuring safety and security for all involved. People working or staying in mental health wards need to be safe and secure but also need to feel safe and secure.