TY - BOOK

T1 - Enacting recovery in an English NHS 'arts for mental health' service

AU - McWade, Brigit

PY - 2014

Y1 - 2014

N2 - This thesis explores the emergence of recovery in/from serious mental health problems as a conceptual frame, and as a set of practices and policy orientations. I provide a specific empirical account of recovery in practice. “Recovery” has multiple meanings and is enmeshed in on-going challenges to the validity of biomedical psychiatry as a medical science. It emerges, in part, out of psychiatric survivor/user activists’ contention that psychiatric discourse prevents the possibility of recovery. In academic literature, it is framed as a new paradigm in mental healthcare in which patients and professionals work in partnership. These multiple iterations of recovery raise questions about what mental (ill) health is and how it should be treated. I investigate how recovery is enacted in contemporary English mental health policy and practice through autoethnographic research with a NHS arts for mental health service called Create, which works with adults categorised as having severe and enduring mental health needs. Drawing upon the material-semiotic approach of feminist technoscience studies and its concept of enactment, I ask: What are the practices of recovery here? What forms of evidence are appropriate in demonstrating recovery? What does recovery as set of a socio-material practices tell us about mental (ill) health more broadly?I find that in Create the focus on art activity and an attention to aesthetics facilitates collaborative care partnerships, helping service-users to feel differently about themselves. I argue that recovery is enacted spatially, temporally and relationally in these located care practices. Nevertheless, there are paradoxes in the implementation of recovery-orientated practice in mental health services, which Create service-users and service-staff continually negotiate.

AB - This thesis explores the emergence of recovery in/from serious mental health problems as a conceptual frame, and as a set of practices and policy orientations. I provide a specific empirical account of recovery in practice. “Recovery” has multiple meanings and is enmeshed in on-going challenges to the validity of biomedical psychiatry as a medical science. It emerges, in part, out of psychiatric survivor/user activists’ contention that psychiatric discourse prevents the possibility of recovery. In academic literature, it is framed as a new paradigm in mental healthcare in which patients and professionals work in partnership. These multiple iterations of recovery raise questions about what mental (ill) health is and how it should be treated. I investigate how recovery is enacted in contemporary English mental health policy and practice through autoethnographic research with a NHS arts for mental health service called Create, which works with adults categorised as having severe and enduring mental health needs. Drawing upon the material-semiotic approach of feminist technoscience studies and its concept of enactment, I ask: What are the practices of recovery here? What forms of evidence are appropriate in demonstrating recovery? What does recovery as set of a socio-material practices tell us about mental (ill) health more broadly?I find that in Create the focus on art activity and an attention to aesthetics facilitates collaborative care partnerships, helping service-users to feel differently about themselves. I argue that recovery is enacted spatially, temporally and relationally in these located care practices. Nevertheless, there are paradoxes in the implementation of recovery-orientated practice in mental health services, which Create service-users and service-staff continually negotiate.

KW - Recovery in Mental Health

KW - Mental Health Policy

KW - mental health practices

KW - Mental Health

M3 - Doctoral Thesis

PB - Lancaster University

ER -