“Mad, Bad and Dangerous to Know”: The pervasive socio-medical and spatial coding of mental health day centres

Abstract

This paper explores the experiences of long-term, mental health service users in community day centres. Academic literature often focuses on macro-level analysis of the social, political and geographical position with society of those with mental health distress. In doing so service users can be positioned as a largely homogeneous group who often reside at the boundaries of society due to the negative social representations of mental distress. Community spaces, such as day centres, can be presented as ‘therapeutic spaces’, in which service users engage in consensual and non-judgemental behaviour. Such accounts suggest a high level of mutual camaraderie exists within day centres. However, this approach can negate the realities encountered by service users on a daily basis, where perceived associations with medical ascriptions such as ‘depression’ and ‘schizophrenia’ can influence service users' identity and behaviour, and acceptance by other members. In this paper we develop a relational understanding of the production of day centre space, constituted through discursive and materially-embodied forces. We argue that Spinoza's writings on affect are a particularly useful way to analyse the ways that service user experience is produced through practices that incorporate social and individual discursive activity, which comes to be indelibly linked to bodies' “capacities to act”. In doing so we hope to emphasise how important embodied relational dynamics are to the production and experience of day centres, and the potential value of a Spinozist account of affect to do so. Consequently the paper works up an argument that key spaces in community mental health be explored in terms of the way spaces are produced through affective practices that are inter-personal, rather than shaping service users as a homogeneous group. Key to this process, as we will see, is the role of perceived diagnostic identity, derived from embodied activity, as an organising affective force.