Thriving or Surviving

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Thriving or Surviving?

• RCPsych SW Division
• Buckfast Abbey
• 16th May 2008

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Partnership with Service Users in a Recovery
Environment

• Prof Pat Bracken
• University of Central Lancashire and
• West Cork Mental Health Service

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Partnership in a Recovery Environment

• 1. Introduction
• 2. The Emerging User Movement
• 3. Expertise and the Recovery Approach
• 4. Responding Positively to this Challenge
• 5. Potential Benefits to Our Profession

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Partnership Beyond Consultation

• Consumer orientated society
• Statutory Environment
• Consultation now accepted and widespread
• Mental health service users moving beyond this
• Challenge to the psychopathology framework

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The Icarus Project

• we shared a vision of being bipolar that
  differs radically from the narrow model put forth
  by the medical establishment, and wanted to
  create a space for people like us to articulate
  the way we understand ourselves, our disorder,
  and our place in the world

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20th Century Psychiatry
Focus on technology of diagnosis and treatment
relationships
Social position
Ethics and values
Cultural issues
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Technological paradigm

• Madness/distress as problems to be solved
• Importance of ordering/classification
• Interventions as discrete, measurable items,
  packages
• Includes medical, psychological, social and
  managerial interventions
• Culminates in evidence-based practice

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Modernist Psychiatry

• Primary discourse is technical and
  individualised focused on diagnosis,
  classification, biological explanation, technical
  interventions.
• Other issues become secondary
• ethics, values and priorities,
• meanings and contexts,
• relationships and power

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Recovery challenges the technological approach to
mental health
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Recovery agenda
Discourse centred on -values/ethics -meanings/co
ntexts -relationships/power
Appropriate research
Training priorities
Service models
Use of drugs and therapy
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Arguments against the technological paradigm
1. Philosophical (the limits of positivism and
reductionism) 2. Empirical (how treatments
actually work) 3. Sociological (how progress
actually happens) 4. Political (how best to
overcome social exclusion)
5. Ethical (what users actually say)
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What Service Users Want
the patients in this study valued continuity
of care, attitudes, and a willingness to listen
and learn over specific knowledge on mental
health. This suggests tensions with the direction
of current policy reforms, and it challenges
health professionals assumptions that mental
health expertise is vital to providing care for
patients with serious mental illness (Lester et
al, 2005).
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Recovery agenda
Discourse centred on -values/ethics -meanings/co
ntexts -relationships/power
Appropriate research
Training priorities
Service models
Use of drugs and therapy
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Challenges of Partnership

• Different understanding of
• -the nature of mental illness
• -the nature of expertise
• -training and research priorities
• -service developments
• Importance of critical thinking
• Need for transparency

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Benefits for Psychiatry

• From monologue to dialogue
• New identity emerging for psychiatry
• New formulation of responsibility