Client participation in mental health: shifting positions in decision-making

Individuals with severe mental illness have often been perceived by themselves and others as stigmatised and unable to make decisions about their lives. However, perceptions of mental illness and health care have experienced significant changes; as a result, community-, consumer- and recovery-based...

Full description

Saved in:
Bibliographic Details
Published inNordic social work research Vol. 5; no. 1; pp. 35 - 49
Main Authors Raitakari, Suvi, Saario, Sirpa, Juhila, Kirsi, Günther, Kirsi
Format Journal Article
LanguageEnglish
Published Abingdon Routledge 02.01.2015
Taylor & Francis Ltd
Subjects
client participation
Clients
decision-making
Discursive practices
Health problems
Health services
interaction
Medical decision making
Mental disorders
Mental health
Mental health care
Participation
positioning
Online AccessGet full text

Cover

More Information
Summary:Individuals with severe mental illness have often been perceived by themselves and others as stigmatised and unable to make decisions about their lives. However, perceptions of mental illness and health care have experienced significant changes; as a result, community-, consumer- and recovery-based approaches have been developed. The aim of this article is to deepen our understanding about client participation as interactive and shifting positioning work. It examines how a client constructs him/herself as a decision-maker and how others support or hinder that position. The study is based on 25 mental health client interviews. Findings are reported in three sections that examine: (1) restricted participation; (2) supported participation; and (3) independent participation. It is argued that, when dealing with client participation in mental health, we need to focus on the subtle discursive practices by which clients perform positioning and are given positions. The findings provide a basis for discussing client participation as relational and interactive phenomena. Client participation is bound by client-practitioner interaction as well as by discursive practices. For the client to participate, he/she first needs to accomplish participant positioning, become an actor with a voice and be able to make decisions and choices. This is a crucial (but not easily accomplished) precondition of client participation.
ISSN:2156-857X
2156-8588
DOI:10.1080/2156857X.2014.909875