Stand up for recalcitrance!

McKeown, Mick

doi:10.1111/inm.12239

Cited by 10 publications

(10 citation statements)

References 8 publications

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“…This difference (on whether MR is necessary) has been indicated throughout the literature (Duxbury & Whittington 2005;Pulsford et al 2013). However, notions of 'resistance' or 'recalcitrance' are possible patient reactions (McKeown 2016).…”

Section: Discussionmentioning

confidence: 99%

“…To reduce the use and duration of MR episodes and to improve clinical practice in situations where MR is unavoidable, staff need to appreciate the value of considering possible reasons for patients’ actions and reactions (McKeown ) at the different points in the process of MR. With respect to the ‘pattern of protest’, this study underlines the need for improved staff training regarding behaviour and communication in order to avoid conflicts, engage with patients’ need(s) for dialogue about disagreements, to utilize de‐escalation strategies, and, finally, to improve communication during MR, that is with the aim of reducing the incidence of ‘overt protest reactions’. Moreover, with respect to the ‘pattern of illness’, this study underlines the necessity of information and communication during MR to support patients in being ‘genuinely calm’.…”

Section: Relevance For Clinical Practicementioning

confidence: 99%

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Forensic psychiatric patients’ perceptions of situations associated with mechanical restraint: A qualitative interview study

Tingleff

Hounsgaard

Bradley³

et al. 2018

Int J Mental Health Nurs

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To reduce the use and duration of mechanical restraint in forensic settings and ensure evidence‐based patient care, we need more knowledge about patients’ subjective experiences and perceptions. The aim was to investigate forensic psychiatric patients’ perceptions of situations associated with the use of mechanical restraint and what they perceive as factors impacting the use and duration of mechanical restraint. Twenty participants were interviewed. Four themes were identified through a thematic analysis: ‘overt protest reactions’, ‘silent protest reactions’, ‘illness‐related behaviour’, and ‘genuinely calm’, which together characterize patients’ perceptions of their ways of acting and reacting during mechanical restraint episodes. These themes are linked together in two patterns in the process of mechanical restraint: ‘pattern of protest’ and ‘pattern of illness’. Further research is needed to illuminate the associations between patients’ perceptions of being subjected to mechanical restraint and ways of acting and reacting through the process of mechanical restraint.

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Section: Discussionmentioning

confidence: 99%

Section: Relevance For Clinical Practicementioning

confidence: 99%

Forensic psychiatric patients’ perceptions of situations associated with mechanical restraint: A qualitative interview study

Tingleff

Hounsgaard

Bradley³

et al. 2018

Int J Mental Health Nurs

View full text Add to dashboard Cite

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“…Just as Douglass’ and the abolitionists’ case were not sustained on the back of moral power alone, it also required a “rebellious disposition” of the slaves themselves—in the healthcare context, nurses need to strike a more recalcitrant and rebellious pose (McKeown, ). Despite the pervasive representation of nurses as collectively passive that serves governments and employers interests in curtailing nurses’ power, there is a long history of nursing radicalism and militancy.…”

Section: Recalcitrance and Indignationmentioning

confidence: 99%

No concession without demand

McKeown

2018

Journal of Clinical Nursing

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“…In a similar vein, scholars of public services have noted that despite the seeming omnipresence of neoliberalism, there is ample scope to do something different in the interstitial spaces of life, society and institutions, where the powerful are not always looking (Bondi , Clarke ); resonating somewhat with notions of street‐level bureaucracy (Lipsky , Wells ). Similarly, Law & Mooney () have remarked upon the virtues of recalcitrance within social movements aspiring to transformational change, and there is certainly ample scope for rebellion on the part of service users (and potential staff allies) faced with the lack of choices attendant upon compulsion and coercion into singularly biologically orientated care and treatment regimes (McKeown ; McKeown et al . forthcoming).…”

Section: Neoliberalism: the Con Is Upon Usmentioning

confidence: 99%

Care planning: a neoliberal three card trick

McKeown

Wright

Mercer

2017

Psychiatric Ment Health Nurs

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Introduction The three card game, sometimes called find the queen, is a classic confidence trick, typically taking place on an impromptu table top, set up on pavement or street corner. The tricksters usually operate in teams, pulling in punters and 'losing' games with their fellows to persuade prospective speculators the game is winnable. For our titular purposes the three card trick serves as a metaphor for broader deceits. We are concerned with how well-meaning mental health nurses can enter into a set of apparently rational practices, insisted upon by policy and protocol, seemingly motivated by ideals of care and protection from harm, yet functioning to destroy the very essence of what it might mean to be a caring, progressive practitioner by contributing to a mutuality of alienation that, at the relational level, is the opposite of what services intend to achieve. This may prove to be the case because an external confidence trickster (neoliberalism) is actually in charge, and the real function of the game serves other ends. The whole point of the game is that genuine players can never win, and for the trickster to triumph it is necessary that these punters are willing, gullible and in most circumstances accept losses without too much fuss. When the losers do not go quietly this is referred to in the argot of the con as 'squawking', and personnel are deployed on the periphery to ensure any squawk is minimised. Various strategies can be used to 'cool out the mark', and are analogous to the means by which people are assisted to adjust to life's disappointments in other contexts, including encounters with priests or sundry psy-professionals (Goffman 1952; McKeown et al. 2013). This commentary paper seeks to provoke nursing out of its state of gullibility and self-deception even if this involves painful reflection on the losses inherent in our collective game of mental health care. If we are to defend the importance of mental health nursing we must think more critically about our complicity within oppressive systems of control and do something about it. There is a lengthy critical tradition to draw on. We urge mental health nurses to squawk, asserting a more recalcitrant and rebellious standpoint, preferably in alliance with service users, refusers and survivors. Acknowledging the constraints upon nursing's agency, deficits of power, and structural disadvantage need not default to impotence and inaction: collective resistance is always possible, however difficult the circumstances. The set up: our argument in a nutshell First, we provide a critique of Neoliberalism and consequences for mental health and mental health care. Second we indicate how this might be remedied via democratisation. Care planning can be located within a wider panoply of administrative tasks that implicitly service social governance functions acceded to psychiatry from neo-liberalism under risk society (Beck 1992). We are, thus, concerned with questions of power and control in both society and the management of care and how these are worked ...

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Stand up for recalcitrance!

Cited by 10 publications

References 8 publications

Forensic psychiatric patients’ perceptions of situations associated with mechanical restraint: A qualitative interview study

Forensic psychiatric patients’ perceptions of situations associated with mechanical restraint: A qualitative interview study

No concession without demand

Care planning: a neoliberal three card trick

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