A Narrative Study Exploring Survivor/Service-User Professionals' Accountsof Sharing Personal Experiences at Work

Abstract

Fighting for voice, equal rights and greater power has been central to the survivor/service-user movement. 'User involvement' (UI) can be seen as a State response to this. UI proliferates throughout policies but is neither routine nor extensive. Limitations may relate to contradictions between assumptions/practices underlying UI, and other dominant discourses constructing survivors/service-users (especially with ‘psychosis’) as irrational, incapable and dependent on ‘expert’ professionals. UI neglects survivor/service-user professionals but limited research (Adame, 2011; Lindow & Rook-Matthews, 1998) suggests similarities with 'peer workers'. Aiming to understand the function of UI, this research explored how survivor/service-user professionals negotiate these different discourses, and to what effect, through asking: How and why do mental health professionals who have experienced ‘psychosis’ share their personal experiences in their work? A social constructionist epistemology was employed, with a qualitative, 'unstructured' interview design. Four professionals working in the 'mental health' system in England, who self-reported a label of 'psychosis', participated. Data was analysed using a 'critical poetic breaks' (Emerson & Frosh, 2004) approach to narrative analysis, which sits within Mishler's (1995) politics of narrative group of models, working with 'narrative as praxis' (Mishler, 1999). Different narrative forms storied: a precarious, chameleon-like position; the ability to share changing over time; that being believed is key (and paradoxical); a relationship between ‘crossed-roles’, power and safety. A mirroring of the narratives and UI literature informs an understanding of UI, 'mental illness' and 'professional boundaries' discourses, functioning to maintain power relations. Strategies of resistance are highlighted, with survivor discourse key for constructing an alternative subjectivity. Recommendations are made for research, policy, service planning/delivery, and education/training.