Cultural safety, diversity and the servicer user and carer movement in mental health research

Abstract

This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link AbstractThis paper will be of interest to anyone concerned with a critical appraisal of mental health service users' and carers' participation in research collaboration and with the potential of the post-colonial paradigm of cultural safety to contribute to the service user research [SUR] movement. The history and nature of the mental health field and its relationship to colonial processes provokes a consideration of whether cultural safety could focus attention on diversity, power imbalance, cultural dominance and structural inequality, identified as barriers and tensions in SUR.We consider these issues in the context of state-driven approaches towards SUR in planning and evaluation and the concurrent rise of the SUR movement in the UK and Australia, societies with an intimate involvement in processes of colonisation. We consider the principles and motivations underlying cultural safety and SUR in the context of the policy agenda informing SUR.We conclude that while both cultural safety and SUR are underpinned by social constructionism constituting similarities in principles and intent, cultural safety has additional dimensions. Hence we call on researchers to use the explicitly political and selfreflective process of cultural safety to think about and address issues of diversity, power and social justice in research collaboration. KeywordsCultural safety, diversity, research, power, service users/consumers, carers, mental health, IntroductionThe paper offers a critical appraisal of the participation of mental health service users in research collaboration and the potential of cultural safety to concentrate researchers' attention on power imbalance 1 , cultural dominance and structural inequality 2 informing research practices and mental health service users' experience. According to Kara the literature on mental health service user 3 research involvement 'suggests that power imbalances and identity issues are at the root of most difficulties and gaps ' (Kara 2013, 122).Kara suggests that these matters relate to the diversity 4 of players in mental health research, which, along with service user involvement, is central to policy in both the UK and These similarities between the UK and Australia reflect their close socio-political relationship and shared history in colonial projects and so they were chosen as the context for our discussion. Today both societies grapple with control of bodies, minds and discourse in 1 Power is a contested concept in deep, ongoing philosophical debates. We are indebted to Berger and Luckmann's (1966) social constructionism that overcame the agency [Weber] and structure [Marx] debate in arriving at a concept of power that recognised it as an aspect of social relationships occurring in the dialectic between individuals and structures.2 By structural inequality we mean systematic unequal rewards, access to resources and their control, ...

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