Policy promotes the active participation of those with lived experience of mental health difficulties in UK NHS mental health services, from the level of collaborative care-planning to service delivery, leadership and development. However, research indicates different forms of resistance to the implementation of such service user involvement. This article reports the findings of a qualitative, interview-based study which used Foucauldian discourse analysis and psychoanalytic theory to understand how resistances are produced through the interplay of clinical mental health professionals’ subjectivity and their organisational context. Service user involvement was found to highlight conflicts within clinicians’ roles. Central to this conflict was an ambivalent relationship to the power associated with these roles. Power could protect professionals from work related stresses, but could also be used to dominate, silence and coerce service users in ways that conflicted with the core function of providing care. Whilst important, raising awareness of such conflict will arouse discomfort and resistance where psychological defences are challenged. A parallel is drawn with psychotherapeutic change, in which resistance must be understood and worked with as part of meaningful change.
|Number of pages
|Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine
|Published - 8 Jun 2022
Bibliographical noteFunding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Tim Moore was funded by a National Institute for Health Research (NIHR), Master of Research Clinical Research Studentship for this research project.
© The Author(s) 2022.
- discourse analysis
- health policy
- mental health
- profession and professionalisation