The Negotiation of Identity among People with Mental Illness in Rural Communities

Abstract

Integration and normalization are goals within the community-based care of people with mental illness. The implementation of this care policy has led to increased contact between people with mental illness and so-called normal people and society at large. But we know little about how this change affects the former patients' identity and experience of stigma and stereotyping. This study is based on qualitative interviews with people with mental illness (N=15) living in rural communities in four different municipalities. The focus in the study is on the informants' subjective experiences and the results show that they adapt in different ways, depending on how they negotiate their identity. Those who accept their role as "mental patients" seem to have easier access to services, they experience less stigmatization and fewer conflicts with their surroundings than those who oppose the patient role. Seem from our informants' perspectives there seems to be a simple definition of integration: Being integrated is feeling accepted as yourself. Some implications for policy and mental health services are discussed.

Fighting stigma of mental illness in midsize European countries

“…A qualitative study on psychiatric patients living in Norwegian rural communities showed that they experienced stigmatization as causing isolation and loneliness, low self-esteem, no paid work, lack of money, discrimination, and harassment [43]. A similar study in 2006 concluded that patients who accept their role as ''mental patients'' seemed to gain practical benefits and experienced less stigmatization than patients who are reluctant to accept that role [44].…”

Being candidates in a transitional vocational course: experiences of self, everyday life and work potentials

“…However, the fact that several of the participants in this study resisted being a 'service user', and that this course was located in a sheltered setting raises certain debates about segregation. This dimension is debated in a recent Norwegian qualitative study that revealed that people with mental illness who accepted their role as 'mental patients' felt more included in society than those who resisted their patient role (Ekeland and Bergem 2006).…”

On the outskirts of normality: Young adults with disabilities, their belonging and strategies

“…The welfare actors describe the informants as clients having different kinds of disability identity and social problems (Gubrium & Holstein, 2001). The young adults, however, do not describe themselves in terms of problems, but relate to varying demands in different situations and contexts (Allen, 1994;Ekeland & Bergem, 2006). They believe that they can manage specifi c activities in everyday situations, but also believe that their diffi culties become obvious only in their interactions with various institutional practices such as school, the employment agency, and the child health center.…”

“…The term social identity refers to something that is social and variable and may be described as a dynamic process related to everyday interactions and meetings in time and space, in which individuals may view themselves as similar and different from others (Allen 1994, Ekeland & Bergem, 2006Gubrium & Holstein, 2001;Milner & Kelly, 2009). A social identity is formed and maintained through interaction with our environment and includes processes of involvement and resistance, but also through continuous change and renegotiations (Goffman, 1963;Giddens, 1991;Rapley, Kiernan & Antaki, 1998).…”