This article aims to present the lived experiences of psychiatric service users/survivors who have experienced the transition from institutional care in the 1970s and 1980s to community care services in the 1990s and post-2000s. By using a biographical narrative approach the study compares service users' historical experiences with their contemporary experiences of community and residential care. Sixteen biographical narratives were analysed to explore how mental health services have changed over time, from the perspective of service users/survivors, their families and mental health practitioners. The study examines how the closure of NHS mental hospitals in the 1980s, which were replaced in the 1990s with new types of community and residential care services, has changed the lives of service users/survivors. Thus, the article presents these lived biographical experiences which, for the majority of service users/survivors, were defined by the process of transinstitutionalisation rather than de-institutionalisation, within a neoliberal context.• This article presents empirical data on how institutionalisation has changed for service users/survivors in this study since the 1980s.• The article explores the lives of service users/survivors through their biographical stories to conceptualise changing models of care from their perspectives.• The findings discovered that most service users/survivors in this study were still living in an institutional environment where medication played a significant role in their lives.• Therefore, the article asks the question: to what extent has the neoliberalisation of care impacted on the lives of service users/survivors in this study? mad studies; trans-institutionalisation; neoliberalism; residential care; biographical experiences; mental illness
This article draws on contemporary and classical psycho–political theorists to conceptualise ‘mental illness’ as a social construct. The research employs a Mad Studies and anti-psychiatry perspective to reframe ‘mental illness’ from an individualised pathological defect to a socially constructed reality (Foucault, 1967; Menzies et al., 2013). The study applies a qualitative biographical methodology to analyse the subjectivities of people with severe mental health problems, their family members and mental health practitioners. In this study, once individuals were conceptualised as pathologically ‘ill’ they were then medicated and often institutionalised as a form of ‘treatment’. The findings present a theoretical analysis of participants’ subjectivities to examine historic and contemporary psychiatric practices. The article will conclude by discussing how Mad Studies can offer social work practice an alternative theoretical standpoint to conceptualise ‘mental illness’ as a social rather than a pathological phenomenon.Keywords: mad studies; anti-psychiatry movement; ‘mental illness’; biographical methodology; institutionalisation; medicalisation; family
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