This article discusses findings from an ethnographic research study looking at the ways in which children's participation rights are incorporated within an adolescent mental health inpatient unit. The practitioners working within this setting have reinterpreted the concept of 'participation' to suit a coercive agenda associated with the authoritarian medical model of treatment used within child psychiatry. Indeed, the use of the term 'participation' has become a tool to enforce children's compliance with adult (and practitioner) determined treatment plans. For the most part, the barriers to according children's participation rights within this setting relate to the institution's and practitioners' protectionist stance vis-à-vis children who are deemed informally to be both vulnerable and incompetent.

Children's participation rights, embedded within legislation and policies, are increasingly becoming important in terms of their meaningful implementation in mental health practice. This paper explores ways that adolescents within an inpatient unit voice their opinions, based on participant observation, interviews and the analysis of documents. The voices of patients were encouraged only within the parameters of a specific form, content, time and place. The implications of these findings are discussed in relation to the culture of participation within CAMHS.

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This article mobilises transdisciplinary inquiry to explore and deconstruct the often-used comparison of racialized/colonized people, intellectually disabled people and mad people as being like children. To be childlike is a metaphor that is used to denigrate, to classify as irrational and incompetent, to dismiss as not being knowledge-holders, to justify governance and action on others' behalf, to deem as being animistic, as undeveloped , underdeveloped or wrongly-developed, and, hence, to subjugate. We explore the political work done by the metaphorical appeal to childhood, and particularly the centrality of the metaphor of childhood to legitimising colonialism and white supremacy. The article attends to the ways in which this metaphor contributes to the shaping of the material and discursive realities of racialized and colonized others as well as those who have been psychiatrized and deemed 'intellectually disabled'. Further, we explore specific metaphors of child-colony, and child-mad-'crip'. We then detail the developmental logic underlying the historical and continued use of the metaphorics of childhood and explore how this makes possible an infantilisation of colonized peoples and the global South more widely. The material and discursive impact of this metaphor on children's lives, and particularly children who are racialized, colonized, and/or deemed mad or 'crip', is then considered. We argue that complex adult-child relations, sane-mad relations and Western-majority world relations within global psychiatry, are situated firmly within pejorative notions of what it means to be childlike , and reproduce multi-systemic forms of oppression that, ostensibly in their 'best interests', govern children and all those deemed childlike .

Most of the quantitative literature focuses on the many risks and negative outcomes for children. However, qualitative studies suggest positive outcomes such as strong parent-child relationships, which demand further attention both in research and in practice.