Psychiatry, mental health nurses, and invisible power: Exploring a perturbed relationship within contemporary mental health care

Abstract

Interpersonal relationships, although considered to be the cornerstone of therapeutic engagement, are replete with issues of power; yet, the concept of 'invisible power' within such formal mental health care relationships is seldom explored and/or critiqued in the literature. This paper involves an examination of power in the interpersonal relationship between the mental health nurse and the consumer. Issues of power are emphasized by drawing on examples from clinical experiences, each of which is then deconstructed as an analytical means to uncover the different layers of power. This examination highlights the existence of both obscure and seldomly acknowledged invisible manifestations of power that are inherent in psychiatry and interpersonal mental health nursing. It also identifies that there is an orthodoxy of formal mental health care that perhaps is best described as 'biopsychiatry' (or 'traditional psychiatry'). Within this are numerous serious speech acts and these provide the power for mental health practitioners to act in particular ways, to exercise control. The authors challenge this convention as the only viable discourse: a potentially viable alternative to the current of formal mental health care does exist and, most importantly, this alternative is less tied to the use of invisible power.