How do “mental health professionals” who are also or have been “mental health service users” construct their identities?
Holttum, S., Richards, J. and Springham, N. 2016. How do “mental health professionals” who are also or have been “mental health service users” construct their identities? SAGE Open. 2016, pp. 1-14. https://doi.org/10.1177/2158244015621348
|Authors||Holttum, S., Richards, J. and Springham, N.|
“Mental health professionals” are increasingly speaking out about their own experiences of using mental health services. However, research suggests that they face identity-related dilemmas because social conventions tend to assume two distinct identities: “professionals” as relatively socially powerful and “patients” as comparatively powerless. The aim of this study was, through discourse analysis, to explore how “mental health professionals” with “mental health service user” experience “construct” their identity. Discourse analysis views identity as fluid and continually renegotiated in social contexts. Ten participants were interviewed, and the interviews were transcribed and analyzed. Participants constructed their identity variously, including as separate “professional” and “patient” identities, switching between these in relation to different contexts, suggesting “unintegrated” identities. Participants also demonstrated personally valued “integrated” identities in relation to some professional contexts. Implications for clinical practice and future research are explored. Positive identity discourses that integrate experiences as a service user and a professional included “personhood” and insider “activist,” drawing in turn on discourses of “personal recovery,” “lived experience,” and “use of self.” These integrated identities can potentially be foregrounded to contribute to realizing the social value of service user and other lived experience in mental health workers, and highlighting positive and hopeful perspectives on mental distress.
|Keywords||Mental health; identity; professional; discourse|
|Journal citation||2016, pp. 1-14|
|Digital Object Identifier (DOI)||https://doi.org/10.1177/2158244015621348|
|12 Jan 2016|
|Publication process dates|
|Deposited||14 Jan 2016|
|Accepted||19 Nov 2015|
Adame A. L. (2014). "There needs to be a place in society for madness": The psychiatric survivor movement and new directions in mental health care. Journal of Humanistic Psychology, 54, 456-475.
Adame A. L. (2011). Negotiating discourses: The dialectical identities of survivor-therapists. The Humanistic Psychologist, 39, 324-337.
Adame A. L., Kundon R. M. (2007). Beyond the counter-narrative: Exploring alternative narratives of recovery from the psychiatric survivor movement. Narrative Inquiry, 17, 157-178.
Adame A. L., Kundon R. M. (2008). Recovery and the good life: How psychiatric survivors are revisioning the healing process. Journal of Humanistic Psychology, 48, 142-164.
Ahmed A. (2007). Prejudice within. British Journal of Psychiatry Bulletin, 31, 153.
Andersean R., Oades L., Caputi P. (2003). The experience of recovery from schizophrenia: Towards an empirically-validated stage model. Australian & New Zealand Journal of Psychiatry, 37, 586-594.
Angermeyer M. C., Holzinger A., Carta M. G., Schomerus G. (2011). Biogenetic explanations and public acceptance of mental illness. British Journal of Psychiatry, 199, 367-372. doi:10.1192/bjp.bp.110.085563
Barrett N. M., Pratt C. W., Basto P. M., Gill K. J. (2000). Integrating consumer providers into a service delivery system: The role of education and credentials. Psychiatric Rehabilitation Skills, 4, 82-104.
Basset T., Campbell P., Anderson J. (2006). Service user/survivor involvement in mental health training and education: Overcoming the barriers. Social Work Education, 25, 393-402.
Bassman R. (2001). Whose reality is it anyway? Consumers/survivors/ex-patients can speak for themselves. Journal of Humanistic Psychology, 41, 11-35.
Benwell B., Stokoe E. (2006). Discourse and identity. Edinburgh, Scotland: Edinburgh University Press.
Beresford P. (2005). The evaluation of the support time and recovery worker programme. London, England: Social Care Workforce Research Unit, King’s College London.
Berry C., Hayward M. I., Chandler R. (2011). Another rather than other: Experiences of peer support specialist workers and their managers working in mental health services. Journal of Public Mental Health, 10, 238-249.
Billig M. (1991). Ideology and options. London, England: SAGE.
Billig M., Condon S., Edwards D., Gane M., Middleton D., Radley A. (1988). Ideological dilemmas: A social psychology of everyday thinking. Beverly Hills, CA: SAGE.
Burling L., Webb S. (2005, April). It helped to build me up, knowing that she been there and had got through it herself. Mental Health Today, p. 18.
Cain N. R. (2000). Psychotherapists with personal histories of psychiatric hospitalization: Countertransference in wounded healers. Psychiatric Rehabilitation Journal, 24, 22-28.
Charlemagne-Odle S., Harmon G., Maltby M. (2014). Clinical psychologists’ experiences of personal significant distress. Psychology and Psychotherapy: Theory, Research and Practice, 87, 237-252.
Clarke S. (2012, November 23). Dr Simon Clarke—Living in glass-walled asylums: The schizophrenia commission report. The Institute of Mental Health Blog (Nottingham). Retrieved from http://imhblog.wordpress.com/2012/11/23/dr-simon-clarke-living-in-gl...
Davies B., Harré R. (1990). Positioning: The discursive production of selves. Journal for the Theory of Social Behaviour, 20, 44-63.
Davis C. (2003). Workers, professions and identity. In Henderson J., Alkinson D. (Eds.), Managing care in context (pp. 189-210). London, England: Routledge.
Deegan P. E. (1987). Recovery, rehabilitation and the conspiracy of hope. Paper presented at There’s a Person in Here: The Sixth Annual Mental Health Services Conference of Australia and New Zealand, Brisbane, September 1996.
De Fina A. D., Schiffrin D., Bamberg M. (2006). Discourse and identity. Cambridge, UK: Cambridge University Press.
Department of Health. (2009). New horizons: A shared vision for mental health. Retrieved from http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_109705
Department of Health. (2014). Achieving better access to mental health services by 2020. London, England: Author. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data...
Deutsch C. J. (1985). A survey of therapists’ personal problems and treatment. Professional Psychology: Research and Practice, 16, 305-315.
↵Dyble G., Tickle A., Collinson C. (2014). From end user to provider: Making sense of becoming a peer support worker using interpretative phenomenological analysis. Journal of Public Mental Health, 13, 83-92.
Fisher D. (1994). How community psychiatrists and consumer/survivors can promote mutual empowerment. Lawrence, MA: National Empowerment Center.
Fox V. (2002). I am a mental health professional; My credential: Life experience. Psychiatric Rehabilitation Journal, 26, 99-100.
Frese F. J. (2000). Psychology practitioners and schizophrenia: A view from both sides. Journal of Clinical Psychology, 56, 1413-1426.
Frese F. J.,Davis W. W. (1997). The consumer survivor movement, recovery, and consumer professionals. Professional Psychology: Research and Practice, 28, 243-245.
Friedman A. (2004). New road travelled. Psychiatric Rehabilitation Journal, 28, 195-196.
Gilroy P. J., Carroll L., Murra J. (2001). A preliminary survey of counseling psychologists’ personal experiences with depression and treatment. Professional Psychology: Research and Practice, 33, 402-407.
↵Hansson L., Jormfeldt H., Svedberg P., Svensson B. (2013). Mental health professionals’ attitudes towards people with mental illness: Do they differ from attitudes held by people with mental illness? International Journal of Social Psychiatry, 59, 48-54.
Harding E. (2005). Service user employment in the NHS: A user’s perspective. Psychiatric Bulletin, 29, 268-269.
Harper D. J. (1995). Discourse analysis and “mental health.” Journal of Mental Health, 4, 347-357.
Harré R., Langenhove L. V. (1999). Positioning theory: Moral contexts of intentional action. Oxford, UK: Blackwell.
Health and Care Professions Council. (2014). Your duties as an education provider: Standards of education and training guidance. London, England: Author. Retrieved from http://www.hcpc-uk.org/assets/documents/10001A9DStandardsofeducation...
Hossack A., Wall G. (2005). Service users: Undervalued and underused? The Psychologist, 18, 134-136.
Hui A., Stickley T. (2007). Mental health policy and mental health service user perspectives on involvement: A discourse analysis. Journal of Advanced Nursing, 59, 416-426.
Jackson S. W. (2001). The wounded healer. Bulletin of the History of Medicine, 75, 1-36.
Jetten J., Haslam C., Haslam S. A. (2012). The social cure: Identity, health and well-being. Hove, UK: Psychology Press.
Jhangiani S. J., Vadeboncoeur J. A. (2010). Health care “as usual”: The insertion of positive psychology in Canadian mental health discourse. Mind, Culture, and Activity, 17, 169-184.
Joyce T., Hazelton M., McMillan M. (2007). Nurses with mental illness: Their workplace experiences. International Journal of Mental Health Nursing, 16, 373-380.
Kottsieper P. (2009). Experiential knowledge of serious mental health problems: One clinician and academic’s perspective. Journal of Humanistic Psychology, 49, 173-192.
Leamy M., Bird V., Le Boutillier J., Slade M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. British Journal of Psychiatry, 199, 445-452.
Lemelin R. H. (2006). Running to stand still: The story of a victim, a survivor, a wounded healer—A narrative of male sexual abuse from the inside. Journal of Loss & Trauma, 11, 337-350.
Linehan M. M. (2011). Expert on mental illness reveals her own fight. New York Times. Retrieved from http://www.nytimes.com/2011/06/23/health/23lives.html?pagewanted=all
MacCulloch T.,Shattell M. (2009). Reflections on a “wounded healer.” Issues of Mental Health Nursing, 30, 135-137.
May R. (2000). Routes to recovery from psychosis: The roots of a clinical psychologist. Clinical Psychology Forum, 146, 6-10.
May R. (2001). Crossing the “them and us” barriers: An inside perspective on user involvement in clinical psychology. Clinical Psychology Forum, 150, 14-17.
Mays N.,Pope C. (2000). Assessing quality in qualitative research. British Medical Journal, 320, 50-52.
McCourt J. (1999). A dilemma of disclosure. Clinical Psychology Forum, 125, 14-16.
Oades L. G., Crowe T. P., Nguyen M. (2009). Leadership coaching transforming mental health systems from the inside out: The Collaborative Recovery Model as person-centred strengths based coaching psychology. International Coaching Psychology Review, 4, 25-36.
Otto R., Goldrick V., Helm S. (2009). Recovery: Three lives, one workplace. American Journal of Psychiatric Rehabilitation, 12, 124-142.
Parker I. (1992). Discourse dynamics: Critical analysis for social and individual psychology. London, England: Routledge.
Perkins R., Rinaldi M., Hardisty J. (2010). Harnessing the expertise of experience: Increasing access to employment within mental health services for people who have themselves experienced mental health problems. Diversity in Health and Care, 7, 13-21.
Perkins R., Slade M. (2012). Recovery in England: Transforming statutory services? International Review of Psychiatry, 24, 29-39.
Pilgrim D. (2009). CBT in the British NHS: Vague imposition or imposition of vagueness? European Journal of Psychotherapy & Counselling, 11, 323-339.
Potter J., Wetherell M. (1987). Discourse and social psychology: Beyond attitudes and behaviour. London, England: SAGE.
Potter J., Wetherell M. (1995). Discourse analysis. In Smith J., Harré R., Van Lamhemhove R. (Eds.), Rethinking methods in psychology (pp. 80-92). London, England: SAGE.
ResearchNet. (2011). Commentary by members of ResearchNet to “On learning from being the in-patient.” International Journal of Art Therapy, 16, 66-69.
Roberts G., Boardman J. (2013). Understanding “recovery.” Advances in Psychiatric Treatment, 19, 400-409.
Roberts G., Boardman J. (2014). Becoming a recovery-oriented practitioner. Advances in Psychiatric Treatment, 20, 37-47.
Royal College of Psychiatrists. (2008). Fair deal for mental health: Our manifesto for a 3 year campaign dedicated to tackling inequality in mental healthcare. London, England: Author.
Rucinski J., Cybulska E. (1985). Mentally ill doctors. British Journal of Hospital Medicine, 33, 90-94.
Sampson E. E. (1993). Identity politics: Challenges to psychology’s understanding. American Psychologist, 48, 1219-1230.
Schiff A. C. (2004). Recovery and mental illness: Analysis and personal reflections. Psychiatric Rehabilitation Journal, 27, 212-218.
Schulze B. (2007). Stigma and mental health professionals: A review of the evidence on an intricate relationship. International Review of Psychiatry, 19, 137-155.
Shepherd G.,Boardman J., Burns M. (2009). Implementing recovery: A new framework for organisational change. London, England: Sainsbury Centre for Mental Health.
Shepherd G., Boardman J., Burns M. (2010). Implementing recovery: A methodology for organizational change. London, England: Sainsbury Centre for Mental Health.
Shepherd G., Boardman J., Slade M. (2008). Making recovery a reality. London, England: Sainsbury Centre for Mental Health.
Sherman M. D. (1996). Distress and professional impairment due to mental health problems among psychotherapists. Clinical Psychology Review, 16, 299-315.
Slade M. (2009). Personal recovery and mental illness: A guide for mental health professionals. Cambridge, UK: Cambridge University Press.
Slade M. (2013). 100 ways to support recovery. London, England: Rethink Mental Illness. Retrieved from https://www.rethink.org/about-us/commissioning-us/100-ways-to-suppor...
Stanley N.,Manthrope J., White M. (2007). Depression in the profession: Social workers’ experiences and perceptions. British Journal of Social Work, 37, 281-298.
St.Claire L., Clucas C. (2012). In sickness and in health: Influences of social categorizations on health-related outcomes. In Jetten J., Haslam C., Haslam S. A. (Eds.), The social cure: Identity, health and well-being (pp. 75-96). Hove, UK: Psychology Press.
Stuber J. P., Rocha A., Christian A., Link B. G. (2014). Conceptions of mental illness: Attitudes of mental health professionals and the general public. Psychiatric Services, 65, 490-497.
Substance Abuse and Mental Health Services Administration. (2012). SAMHSA’s working definition of recovery: 10 guiding principles of recovery. Rockville, MD: Author. Retrieved from http://www.mentalhealth.gov/basics/recovery/index.html
Sweeney A., Beresford P., Faulkner A., Nettle M., Rose D. (2009). This is survivor research. Ross-on-Wye, UK: PCCS Books.
Tsai A. (2002). The experiences of a “prosumer.” Psychiatric Rehabilitation Journal, 26, 206-207.
Tse S.,Cheung E., Kan A., Ng R., Yau S. (2012). Recovery in Hong Kong: Service user participation in mental health services. International Review of Psychiatry, 24, 40-47.
Turner J. C., Hogg M. A., Oakes P. J., Reicher S. D., Wetherell M. S. (1987). Rediscovering the social group: A self-categorization theory. New York, NY: Basil Blackwell.
Ivan Erp N. H.,Hendriksen-Favier A. I., Boer M. (2010). Training and employment of consumer provider employees in Dutch mental health care. Psychiatric Rehabilitation Journal, 34, 65-67.
Walsh J., Stevenson C., Cutcliffe J., Zinck K. (2008). Creating a space for recovery-focused psychiatric nursing care. Nursing Inquiry, 15, 251-259.
Warne T., Stark S. (2004). Service users, metaphors and teamworking in mental health. Journal of Psychiatric and Mental Health Nursing, 11, 654-661.
Weltz D. (2003). Call me anti-psychiatry activist—Not “consumer.” Ethical Human Sciences and Services, 5, 71-72.
Wetherell M. (1998). Positioning and interpretative repertoires: Conversation analysis and post-structuralism. Discourse & Society, 9, 387-412.
Willig C. (2008). Introducing Qualitative Research in Psychology. Maidenhead, UK: McGraw-Hill Open University Press.
Wong Y.-L. I., Stanton M. C., Sands R. G. (2014). Rethinking social inclusion: Experiences of persons in recovery from mental illness. American Journal of Orthopsychiatry, 84, 685-695.
Woods A., Springham N. (2011). On learning from being the in-patient. International Journal of Art Therapy, 16, 60-68.
Yarek C. (2008). Ethics in peer support work. Journal of Ethics in Mental Health 3 (1):11.
2views this month
1downloads this month