Critical thinking and contemporary mental health care: Michel Foucault's “history of the present”

Abstract

In order to be able to provide informed, effective and responsive mental health care and to do so in an evidence-based, collaborative and recovery-focused way with those who use mental health services, there is a recognition of the need for mental health professionals to possess sophisticated critical thinking capabilities. This article will therefore propose that such capabilities can be productively situated within the context of the work of the French philosopher Michel Foucault, one of the most challenging, innovative and influential thinkers of the 20th century. However, rather than focusing exclusively upon the content of Foucault's work, it will be suggested that it is possible to discern a general methodological approach across that work, a methodological approach that he refers to as "the history of the present." In doing so, Foucault's history of the present can be understood as a productive, albeit provisional, framework in which to orientate the purpose and process of critical thinking for mental health professionals by emphasizing the need to both historicize and politicize the theoretical perspectives and therapeutic practices that characterize contemporary mental health care.

A Foucauldian discourse analysis of media reporting on the nurse‐as‐hero during COVID‐19

“…The genealogy traces the construction of institutions and practices that have been created as a result of specific struggles, events and exercises of power (Garland, 2014 ). Foucault called the culmination of the genealogy a ‘history of the present’, which demonstrates how the seemingly unquestionable current political and social climate of the discourse has actually been historically constructed (Roberts, 2017 ). While our archive focuses on Ontario, Canada, the genealogy will focus on the caring discourse in a North American and European context, as the two developed in tandem (Reverby, 1987 ).…”

Combining Critical Ethnography and Critical Discourse Analysis in Mental Health Nursing Research

“…We purport that combining critical ethnography with CDA allows researchers to maintain a critical stance throughout the research process, which is essential to creating new knowledge that challenges routine ways of thinking about clinical problems and leads to new ways of seeing clinical processes, practices, and environments. As has been demonstrated by other authors (Berring et al, 2015;Holmes, 2002;Holmes et al, 2006;Perron, 2012;Perron & Holmes, 2011;Reddy, 2016;Roberts, 2017), a critical lens can alert the researcher to power structures that lie behind status quo thinking. This constitutes a crucial step in undoing the stereotyping, stigma, and shame that continues to be a factor in how people with a diagnosis of mental illness experience society at large, healthcare institutions, and healthcare providers.…”

How identity is produced and experienced in the context of mandated community‐based mental health care: An application of the theories of Grosz and Foucault

“…As power shifted from religious institutions to health‐care systems, psychiatry developed a special and important role in the totalizing and individualizing power of governmentality (Foucault, 1982; Rose, 1999). In this way, psychiatry represented a new kind of subjugation of the subject, one that was not just physical, but that required observation and judgment of thoughts and emotions (Leoni et al, 2013), and the development of psychological sciences and methods, as used in maintenance of well‐being for the general population, were a technology for constituting the subject (Dreyfus, 1987; Roberts, 2017; Rose, 1999). The experts and expert bodies of knowledge that have proliferated around this (diagnosis, pharmaceutical management, psychotherapeutic techniques, legal apparatuses), Foucault argued, beget and substantiate an imbalance of power.…”

“…Ultimately, this reflection leads to opportunities to conceive of approaches to SPMI that explicitly acknowledge that structural and political forces play a role in individual well‐being, and which are designed to mediate and/or resist the inscriptive power of psychiatric care on subjective identity. Examining that which appears to be self‐evident within mental health care opens up new ways of seeing problems (Roberts, 2017), and new ways of seeing problems has the potential to impact interindividual relationships and individual identity. As Foucault stated, the purpose of the concept of governmentality is to “bring out the freedom of the subject and its relationship to others” (Foucault, 1997a, p. 300), that is “to liberate us from the type of individuation which is linked to the state” and thereby “promote new forms of subjectivity” (Foucault, 1982, p. 785).…”