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Responsibilization and recovery: shifting responsibilities on the journey through mental health care to social engagement

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Abstract

This paper examines the trajectory of 32 service users through the mental health care system on the path to recovery. It offers a critical appraisal of the processes whereby mental health and social care services attempt to responsibilize the service user in the process of delivering recovery-oriented services. Responsibilization was often found to be onerous and counterproductive and appeared to work against their strivings for autonomy. Acting responsibly was aligned with following instructions from health professionals and managing the demands one made on services. By contrast, participants who described their involvement in civil society organisations described a good deal of effort on their own and other’s behalf, but this was not seen as burdensome, had a sense of being freely chosen and represented a source of satisfaction and accomplishment, scarcely felt as responsibility at all. Meaningful, purposive shared activity was more highly valued and enjoyed. Didactic responsibilization was something imposed on the abject or marginalised individual in the process of engaging with mental health services. However, beyond this, a number of participants had found a more subtle way of acting responsibly through civic engagement in the unmanaged spaces of social life.

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References

  • Anthony, W.A. 1993. Recovery from mental illness: The guiding vision of the mental health service system in the 1990’s. Psychosocial Rehabilitation Journal 16 (4): 11–23.

    Google Scholar 

  • Argüelles, L., I. Anguelovski, and E. Dinnie. 2017. Power and privilege in alternative civic practices: Examining imaginaries of change and embedded rationalities in community economies. Geoforum 86: 30–41.

    Google Scholar 

  • Argyle, E., and G. Winship. 2018. Creative practice with clay—a mutual route to recovery, Journal of Applied Arts and Health, 9 (3) (In Press.).

  • Atanasova, D., N. Koteyko, B. Brown, and P. Crawford. 2017. Representations of mental health and arts participation in the national and local British press, 2007–2015. Health 23 (1): 3–20. https://doi.org/10.1177/1363459317708823.

    Article  Google Scholar 

  • Baker, S., B. Brown, and H. Davies. 2013. ‘We always invite residents to come along…’ Discourses of citizenship among local government stakeholders. Contemporary Wales 26: 205–223.

    Google Scholar 

  • Bauman, Z. 2002. Foreword: Individually, together. In Individualization, ed. U. Beck and E. Beck-Gernsheim, xiii–xx. London: Sage Publications.

    Google Scholar 

  • Bickerdike, L., A. Booth, P.M. Wilson, K. Farley, and K. Wright. 2017. Social prescribing: Less rhetoric and more reality. A systematic review of the evidence. British Medical Journal Open 7: e013384. https://doi.org/10.1136/bmjopen-2016-013384.

    Article  Google Scholar 

  • Blaney, P.H. 2015. Medical model of mental disorders. In The encyclopedia of clinical psychology, ed. R.L. Cautin and S.O. Lilienfeld, 1767–1772. Malden, MA: Wiley-Blackwell. https://doi.org/10.1002/9781118625392.wbecp382.

    Chapter  Google Scholar 

  • Bostock, W.W. 2002. Atrocity, mundanity and mental state. Journal of Mundane Behaviour 3 (3): 351–365.

    Google Scholar 

  • Braslow, J.T. 2013. The manufacture of recovery. Annual Review of Clinical Psychology 9: 781–809.

    Google Scholar 

  • Brayton, S. 2017. Mental illness, late capitalism, and the socioeconomic “psychopath” in CBS’s. Elementary, Popular Communication 15 (4): 283–295.

    Google Scholar 

  • Breen, K. 2007. Work and emancipatory practice: Towards a recovery of human beings’ productive capacities. Res Publica 13 (4): 381–414. https://doi.org/10.1007/s11158-007-9039-6.

    Article  Google Scholar 

  • Brown, B., and S. Baker. 2012. Responsible citizens: Individuals, health and policy under neoliberalism. London: Anthem Press.

    Google Scholar 

  • Brown, B., and P. Crawford. 2003. The clinical governance of the soul. Social Science and Medicine 56 (1): 67–81.

    Google Scholar 

  • Brown, B., and N. Manning. 2017. Genealogies of recovery: The framing of therapeutic ambitions. Nursing Philosophy 19 (2): e12195. https://doi.org/10.1111/nup.12195.

    Article  Google Scholar 

  • Burchell, G. 1996. Liberal government and techniques of the self. In Foucault and political reason: Liberalism, neo-liberalism, and rationalities of government, ed. A. Barry, T. Osborne, and N. Rose, 19–36. Chicago: University of Chicago Press.

    Google Scholar 

  • Chametzky, B. 2013. Generalizability and offsetting the affective filter. Grounded Theory Review 12 (3): 35–43.

    Google Scholar 

  • Charmaz, K. 2001. Qualitative interviewing and grounded theory analysis. In Handbook of interview research: Context and method, ed. J. Gubrium and J. Holstein, 675–694. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Clarke, J. 2005. New labour’s citizens: Activated, empowered, responsibilized, abandoned? Critical Social Policy 25: 447–463.

    Google Scholar 

  • Conrad, P. 2005. The shifting engines of medicalization. Journal of Health and Social Behaviour 46 (1): 3–14.

    Google Scholar 

  • Creswell, J.W. 2007. Qualitative inquiry and research design. London: Sage.

    Google Scholar 

  • Das, V. 2004. The signature of the state: The paradox of illegibility. In Anthropology in the margins of the state, ed. V. Das and D. Poole, 225–52. Oxford: James Currey.

    Google Scholar 

  • Dean, M. 2007. Governing societies: Political perspectives on domestic and international rule. Maidenhead: Open University Press.

    Google Scholar 

  • Dej, E. 2016. Psycho-centrism and homelessness: The pathologization/responsibilization paradox. Studies in Social Justice 10 (1): 117–135.

    Google Scholar 

  • Flückiger, C., and M.G. Holtforth. 2008. Focusing the therapist’s attention on the patient’s strengths: A preliminary study to foster a mechanism of change in outpatient psychotherapy. Journal of Clinical Psychology 64 (7): 876–890.

    Google Scholar 

  • Foucault, M. 1977. Discipline and punish: the birth of the prison. London: Penguin.

    Google Scholar 

  • Foucault, M. 1980. Power/knowledge. Brighton: Harvester Wheatsheaf.

    Google Scholar 

  • Foucault, M. 1985. The use of pleasure: The history of sexuality, vol. 2. New York: Vintage Books.

    Google Scholar 

  • Gadermann, A.M., J. Alonso, G. Vilagut, A.M. Zaslavsky, and R.C. Kessler. 2012. Comorbidity and disease burden in the National Comorbidity Survey Replication (NCS-R). Depression and Anxiety 29 (9): 41–51.

    Google Scholar 

  • Garfinkel, H. 1956. Conditions of successful degradation ceremonies. American Journal of Sociology 61 (5): 420–424.

    Google Scholar 

  • Garland, D. 1996. The limits of the sovereign state: Strategies of crime control in contemporary society. British Journal of Criminology 36: 445–471.

    Google Scholar 

  • Glaser, B. 2007. Doing formal grounded theory: A proposal. Mill Valley, CA: Sociology Press.

    Google Scholar 

  • Glaser, B., and A. Strauss. 1967. The discovery of grounded theory. New York: Aldine.

    Google Scholar 

  • Grey, C. 1997. Management as a technical practice: Professionalization or responsibilization? Systems Practice 10 (6): 703–725.

    Google Scholar 

  • Halushka, J. 2017. Managing rehabilitation: Negotiating performance accountability at the frontlines of re-entry service provision. Punishment and Society 19 (4): 482–502.

    Google Scholar 

  • Harper, A., L. Kriegel, C. Morris, H.P. Hamer, and M. Gambino. 2017. Finding citizenship: What works? American Journal of Psychiatric Rehabilitation 20 (3): 200–217.

    Google Scholar 

  • Harper, D., and E. Speed. 2012. Uncovering recovery: The resistible rise of recovery and resilience. Studies in Social Justice 6 (1): 9–25.

    Google Scholar 

  • Hart, E.L. 2017. Women prisoners and the drive for desistance: Capital and responsibilization as a barrier to change. Women and Criminal Justice 27 (3): 151–169.

    Google Scholar 

  • Hindess, B. 1996. Discourses of power: From hobbes to foucault. Oxford: Blackwell.

    Google Scholar 

  • Hofmann, B. 2016. Medicalization and overdiagnosis: Different but alike. Medicine, Health Care and Philosophy 19 (2): 253–264. https://doi.org/10.1007/s11019-016-9693-6.

    Article  Google Scholar 

  • Holtforth, M.G., K. Grawe, and L.G. Castonguay. 2006. Predicting a reduction of avoidance motivation in psychotherapy: Toward the delineation of differential processes of change operating at different phases of treatment. Psychotherapy Research 16 (5): 639–644.

    Google Scholar 

  • Ilcan, S. 2009. Privatizing responsibility: Public sector reform under neoliberal government. Canadian Review of Sociology 46 (3): 207–234.

    Google Scholar 

  • Kim, J.H. 2016. Understanding narrative inquiry: The crafting and analysis of stories as research. London: Sage.

    Google Scholar 

  • Kemshall, H. 2002. Effective practice in probation: An example of “advanced liberal responsibilization”? Howard Journal 41: 41–58.

    Google Scholar 

  • Klassen, A.L. 2017. Spinning the revolving door: The governance of non-compliant psychiatric subjects on community treatment orders. Theoretical Criminology 21 (3): 361–379.

    Google Scholar 

  • Lowenheim, O. 2007. The responsibility to responsibilize: Foreign offices and the issuing of travel warnings. International Political Sociology 1: 203–221.

    Google Scholar 

  • Martin, L.H., H. Gutman, and P. Hutton (eds.). 1988. Technologies of the self: A seminar with Michael Foucault. Amherst: University of Massachusetts Press.

    Google Scholar 

  • McCabe, R., R. Whittington, L. Cramond, and E. Perkins. 2018. Contested understandings of recovery in mental health. Journal of Mental Health 27 (5): 475–481. https://doi.org/10.1080/09638237.2018.1466037.

    Article  Google Scholar 

  • McWade, B. 2016. Recovery-as-policy as a form of neoliberal state making. Intersectionalities 5 (3): 62–81.

    Google Scholar 

  • Mennicken, A. 2008. Connecting worlds: The translation of international auditing standards into post-Soviet audit practice. Accounting, Organizations and Society 33: 384–414.

    Google Scholar 

  • Nordaunet & Saelpor. 2018. How meaningful activities influence the recovery process. Advances in Dual Diagnosis 11 (3): 114–125.

    Google Scholar 

  • O’Malley, P. 1996. Risk and responsibility. In Foucault and political reason: Liberalism, ed. A. Barry, T. Osborne, and N. Rose, 189–207. Neo-Liberalism and Rationalities of Government, London: UCL Press.

    Google Scholar 

  • Perkins, R., S. Ascenso, L. Atkins, D. Fancourt, and A. Williamon. 2016. Making music for mental health: how group drumming mediates recovery. Psychology of Well-Being 6 (11): 1–17.

    Google Scholar 

  • Pyysiainen, J., D. Halpin, and A. Guilfoyle. 2017. Neoliberal governance and ‘responsibilization’ of agents: Reassessing the mechanisms of responsibility-shift in neoliberal discursive environments. Distinktion: Journal of Social Theory 18 (2): 215–235.

    Google Scholar 

  • Rose, N. 1990. Governing the soul: The shaping of the private self. London: Routledge.

    Google Scholar 

  • Rose, N., P. O’Malley, and M. Valverde. 2006. Governmentality. Annual Review of Law and Social Science 2: 83–104.

    Google Scholar 

  • Sherfinsky, M. 2018. Challenges to goals of “Recovery”: A narrative analysis of neoliberal/ableist policy effects on two mothers of young children with autism. Journal of Early Childhood Research 16 (3): 276–290.

    Google Scholar 

  • Tiffany, J. 2006. Respondent-driven sampling in participatory research contexts: Participant-Driven recruitment. Journal of Urban Health 83 (Suppl 1): 113–124.

    Google Scholar 

  • Williamson, C. 2008. The patient movement as an emancipation movement. Health Expectations 11: 102–112. https://doi.org/10.1111/j.1369-7625.2007.00475.x.

    Article  Google Scholar 

  • Winnett, R. 2011. Cameron: Our crisis of confidence. Daily Telegraph, 25 July.

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Acknowledgements

The author gratefully acknowledges the generous support of the Arts and Humanities Research Council grant AH/K003364/1 Creative Practice as Mutual Recovery which supported the writing of this paper.

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  1. De Montfort University, Leicester, UK

    Brian Brown

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Brown, B. Responsibilization and recovery: shifting responsibilities on the journey through mental health care to social engagement. Soc Theory Health 19, 92–109 (2021). https://doi.org/10.1057/s41285-019-00097-x

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