Destabilising social inclusion and recovery, and pursuing 'lines of flight' in the mental health sector

Abstract

People who have been diagnosed with serious mental illness have a long history of confinement, social stigma and marginalisation that has constrained their participation in society. Drawing upon the work of Gilles Deleuze and Felix Guattari, we have used the concepts of: assemblages, major and minor and deterritorialisation to critically analyse two pervasive and ‘taken‐for‐granted’ assemblages in mental health: recovery (including clinical recovery, social recovery and recovery‐oriented practice) and social inclusion. Our analysis explores how dominant and oppressive forces have been entangled with liberating and transformative forces throughout both of these assemblages – with dominant forces engaging in ongoing processes of capture and control, and transformative forces resisting and avoiding capture. In pursuit of social transformation for people categorised with serious mental illness, deterritorialisation is posited as a potential way forward. To have transformation in the lives of mental health service users, we present the possibility that ongoing, disruptive movements of deterritorialisation can unsettle majoritarian practices of capture and control – producing liberating lines of flight.

Therapists’ Experience of Video Consultation in Specialized Mental Health Services During the COVID-19 Pandemic: Qualitative Interview Study

“…Reasons for seeking help from mental health services are often based on negative experiences in relationships and difficulties in coping with everyday life. There is a need to tailor digital services to promote recovery and change in service users’ mental health state, and to support and improve social relations and coping strategies in the context of everyday life [ 6 , 7 ]. Along the continuum of service provision, VC may be used as part of follow-up care in certain phases of the helping process.…”

Fringe or Not Fringe? Strategies for Localizing Supported Accommodation in a Post‐Deinstitutional Era

“…The approach was not to have too many mental health service users in the same accommodation, nor to include too many special accommodations at the same place. This contemporary way of regulating the emergence of what Wolpert et al (1975) in the 70s called "service-dependent ghettos" could be understood as a form of government control in the name of social inclusion, where the majority constitute the normal society in which the minority-those with PDbecome targets for social inclusion (Barlott et al, 2020) The major/minor tension was visible when using the "re-use" strategy. The history of the reused building could entail a risk for experiences, among service users as well as other residents in the neighborhood, of situations where a norm, the major, in this case "host" community meet those outside the norm, the minor, in this case supported accommodation residents (Barlott et al, 2020).…”

“…This contemporary way of regulating the emergence of what Wolpert et al (1975) in the 70s called "service-dependent ghettos" could be understood as a form of government control in the name of social inclusion, where the majority constitute the normal society in which the minority-those with PDbecome targets for social inclusion (Barlott et al, 2020) The major/minor tension was visible when using the "re-use" strategy. The history of the reused building could entail a risk for experiences, among service users as well as other residents in the neighborhood, of situations where a norm, the major, in this case "host" community meet those outside the norm, the minor, in this case supported accommodation residents (Barlott et al, 2020). At the same time, when using the "re-use'' strategy, in terms of localization as access, residents could be understood as being provided with access to social environments and arenas in which they could develop valuable roles and positive identities through identity-enhancing relationships (Slade, 2009) supporting the recovery objective in national policies in another way than when using strategies "fill-in" and "insert.…”

“…Therefore, they are a key for successfully implementing the mental health care reform of community-based services, as the location of supported accommodation may operate to support or hinder social integration and social inclusion (Government Offices of Sweden, 2006). By social inclusion we refer to "a desired goal that requires equality of opportunity and participation in the rudimentary and fundamental functions of society" (Rimmerman, 2013, p. 35), whilst recognizing that social inclusion also operates as a moral imperative for which those diagnosed with PD become targets (Barlott et al, 2020). Such a moral imperative is understood as having both empowering and controlling forces.…”

Inclusion as Assimilation, Integration, or Co-optation? A Post-Structural Analysis of Inclusion as Produced Through Mental Health Research on Peer Support

“…The contestable nature of 'inclusion' has been highlighted in other fields including international development (Calkin, 2015;Cooke & Kothari, 2001a;Koehler et al, 2020), critical race/ethnic studies (Peterson & Åkerström, 2014), health and disability (Marshall, 2012;Pereira & Whiteford, 2013;Taket et al, 2009), mental health (Barlott et al, 2020;Davey & Gordon, 2017;Spandler, 2007;Wright & Stickley, 2013), and mental health service user involvement broadly (Voronka, 2016a;Voronka & Costa, 2019). Challenging 'inclusion' as a fixed and universal concept, these works highlight 'inclusion' as multiple, with versions 'brought into being through different social and material practices' (McWade, 2016, p. 62).…”