Creating a space for recovery‐focused psychiatric nursing care

Abstract

Within contemporary mental health-care, power relationships are regularly played out between psychiatric nurses and service users. These power relationships are often imperceptible to the practicing nurse. For instance, in times of distress, service users often turn to or/and 'construct' discourses, beliefs and knowledge that are at odds with those which psychiatric nurses rely on to inform them of the mental status of the service user. The psychiatric nurse is in the position to impose knowledge onto service users, usually in concurrence with 'traditional or bio-psychiatry', without realizing or failing to acknowledge that the service user may have an alternative explanation of his/her mental health problems/experiences. In this paper, practice examples, based on the experiences of the four authors (from within and outside of services), are used to illustrate this 'hidden' power relationship. The authors use Foucault's ideas about: (i) government; (ii) the knowledge/power nexus and resistance; (iii) and his analytic tool of genealogy to help unravel this paradox within psychiatric nursing practice. The authors also use the emerging discourse of recovery as an alternative (and challenge) to 'traditional bio-psychiatry' and consider the implications for psychiatric nursing practice.

Promoting mental health and wellbeing in practice

“…This idea is based on the concept of recovery and the belief that hope and a joint approach between the individual and the practitioner in identifying need will ultimately bring about the best outcomes in terms of an individual's well-being. This is a shift from the traditional bio psychiatry model in which the practitioner "imposes knowledge" (Walsh et al, 2008) and identifies the need for the individual from an already established assessment tool. In this respect the starting point for this working model cannot be based upon any pressure to conform with a medical model or adopt prescriptive practises (Pearson ,2010).…”

Panoptic Power and Mental Health Nursing—Space and Surveillance in Relation to Staff, Patients, and Neutral Places

“…Although surveillance in the context of mental health systems does not necessarily take place in a physical space such as the Panopticon (i.e., as an optical system), its operation produces similar effects (Walsh, Stevenson, Cutcliffe, & Zinck, 2008). Counclelis (1992) identified different kinds of locations: absolute spaces, such as points, lines and areas; and relative spaces, for example, ways, domains, and places.…”

Exploring the Process of Digital Storytelling in Mental Health Research

“…This has relevance in mental health where dominant biomedical definitions of mental illness largely subjugate the "expert by experience" knowledge base, ignoring the important social, relational, and historical aspects of human distress (Aho, 2008;Crowe, 2006;Walsh et al, 2008). Authors state that digital storytelling can provide a forum for people defined as mentally ill to represent themselves as capable, creative, knowledgeable people, and that the process supports questioning of dominant biomedical notions of disease and disability LaMarre & Rice, 2016;Rice et al, 2015).…”

“…Under a biomedical model, mental illness is treated as biogenetic in origin, and personal experiences are often perceived as meaningless symptoms of an individual disease process (Aho, 2008;Walsh, Stevenson, Cutcliffe, & Zinck, 2008). Consumers and carers have few opportunities to tell their story, have it understood, acknowledged, and acted upon outside the purview of psychiatric symptoms and treatment (Aho, 2008;Crowe, 2006;Walsh et al, 2008).…”

“…Consumers and carers have few opportunities to tell their story, have it understood, acknowledged, and acted upon outside the purview of psychiatric symptoms and treatment (Aho, 2008;Crowe, 2006;Walsh et al, 2008).…”