'Psychiatry is a risk business': the construction of mental health service users as objects of risk: a multiple case study inquiry

Felton, Anne (2015) 'Psychiatry is a risk business': the construction of mental health service users as objects of risk: a multiple case study inquiry. PhD thesis, University of Nottingham.

PDF (Thesis - as examined) - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (2MB) | Preview


The emergence of recovery as an important philosophy in contemporary mental health care, alongside increasing levels of coercion has drawn attention to the potential for conflicting influences in mental health practice. This thesis examines how such conflicts may be situated in the historical, legal and professional foundation of mental health services, presenting an argument to suggest this exposes mental health professionals to tensions in decision-making.

Inspired by my own experiences as a mental health nurse, this qualitative interpretive inquiry employed multiple case studies to explore whether and how mental health practitioners perceive and experience potential tensions that may arise from delivering care and enforcing control. Data was collected using interviews with mental health professionals and observations in an acute in-patient ward and assertive outreach team. Data analysis using a theory building approach in case study research was adopted to develop an explanatory model which suggests service users are constructed as objects of risk.

Hilgartner’s (1992) theory has been employed to support explanations that people with mental health problems are defined and treated in terms of risk. Such a process is enabled by a spatial, narrative and moral distance that is created between service users and professionals. The construction of service users as objects of risk is influenced by professional, organisational and social contexts. However, displacement from the status of risk object occurred when some professionals maintained proximity to service users’ subjective experiences.

The study has underlined the importance of raising awareness that recovery values are not being realised in mental health practice. It has highlighted problems with the language of risk and proposed strategies that may enhance opportunities for professionals to remain connected to service users’ narratives through dialogue.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Repper, Julie
Avis, Mark
Keywords: Risk, Recovery, Mental Health, Case Study
Subjects: W Medicine and related subjects (NLM Classification) > WM Psychiatry
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Health Sciences
Item ID: 29788
Depositing User: Felton, Anne(staff)
Date Deposited: 23 Mar 2016 13:23
Last Modified: 16 Dec 2017 17:33
URI: https://eprints.nottingham.ac.uk/id/eprint/29788

Actions (Archive Staff Only)

Edit View Edit View