Inventing Mental Health First Aid: The Problem of Psychocentrism

DeFehr, Jan N.

doi:10.26522/ssj.v10i1.1326

Cited by 31 publications

(14 citation statements)

References 60 publications

(46 reference statements)

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“…The operational logic (Astbury and Leeuw, 2010) of our intervention mirrors other psycho-educational courses delivered at the worksite, such as Mental Health First Aid (MHFA). However, although MHFA opens up conversations about mental health, it does not change organisational culture (Narayanasamy et al , 2018), and MFHA has not had a noticeable impact on encouraging employees to seek help (Attridge, 2012; DeFehr, 2016; Knaak et al , 2018; Morgan et al , 2018). MFHA may in fact reinforce stigma by using psychiatric diagnoses that can create a “them and us” culture, with providers seen as mentally healthy and recipients as unhealthy (Corrigan, 2017; DeFehr, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…However, although MHFA opens up conversations about mental health, it does not change organisational culture (Narayanasamy et al , 2018), and MFHA has not had a noticeable impact on encouraging employees to seek help (Attridge, 2012; DeFehr, 2016; Knaak et al , 2018; Morgan et al , 2018). MFHA may in fact reinforce stigma by using psychiatric diagnoses that can create a “them and us” culture, with providers seen as mentally healthy and recipients as unhealthy (Corrigan, 2017; DeFehr, 2016). The “othering” of people with mental health problems is also possible when managers are trained apart from employees, as if managers cannot have mental health problems.…”

Section: Discussionmentioning

confidence: 99%

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A redesigned training and staff support programme to enhance job retention in employees with moderate-severe depression

Walker

Dobbing

2021

MHSI

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Purpose Closing the treatment gap in depression is vital to prevent people from losing their jobs. Delivering group-based interventions at work could reach more employees than delivering 1:1 interventions in a clinical setting. This study aims to redesign a Treatment Programme to make it more acceptable and accessible for employees with depression. Design/methodology/approach A mixed-methods exploratory sequential design with a high level of stakeholder consultation was used to redesign an interdisciplinary Work-focussed Relational Group CBT Treatment Programme for moderate-severe depression. Qualitative data from focus groups and quantitative data from a small feasibility study were integrated to develop the new Training (and Staff Support) Programme (TSSP), which was fully specified and manualised in line with the Template for Intervention Description and Replication (TIDieR) for future delivery. Findings Focus groups identified a need for improved acceptability and accessibility of the tertiary preventative Work-focussed Relational Group CBT Treatment Programme. This programme was, therefore, simplified for delivery by peer facilitators at the worksite as an intervention for all employees rather than an indicated/targeted intervention for only those with symptoms/risk of depression. The TSSP comprised a compulsory trauma-informed educational/experiential workshop over four days plus optional open-ended, peer-led base groups set up and run by volunteer peer facilitators. Research limitations/implications The focus groups comprised a convenience sample who knew the researchers as a colleague or therapist, so there is a risk of selection or relationship bias. They were not involved in the data analysis which undermines the element of co-production and increases the risk of analytic or confirmation bias. Practical implications Delivering the new intervention in a group format will require peer facilitators to acquire skills in co-facilitation using a structured-directive leadership style and an awareness of the potential side effects of group-based interventions. Social implications The worksite TSSP provides a democratic learning space and empowers employees to stay at work by self-managing their symptoms and by challenging the interpersonal dynamics and organisational structures that might precipitate and perpetuate depression. Originality/value This intervention is fully specified and manualised with an explicit programme theory, unlike most universal worksite-based CBT programmes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A redesigned training and staff support programme to enhance job retention in employees with moderate-severe depression

Walker

Dobbing

2021

MHSI

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“…Mass media, inclusive of media technologies such as the internet, functions as a fluid space of socially shared knowledge or (perceived) truths, in which public discourses are actively made and remade, providing a "complex epistemic context" to analyze normative constructions (Ohlsson, 2018, p.298). The presence of contemporary anti-stigma or awareness campaigns within mass media operate as discursive mechanisms to produce and reproduce dominant discourses related to madness and distress (Oute et al, 2018), in which biomedical constructions and psychocentric perspectives (Rimke, 2016; see also Rimke, 2011;DeFehr, 2016;Dej, 2016) dominate within the mental health paradigm (Beresford, 2019). According to Dej (2016), "psychocentrism is a governing neoliberal rationality that pathologizes human problems and frames individuals as responsible for socially structured inequalities" (p.117) according to a "human deficit model" (Rimke, 2016, p.8).…”

Section: Mass Media and Psychocentrismmentioning

confidence: 99%

“…Rimke (2016) refers to the western psy-complex and the "psy-industry" (p.5) as encompassing all health and helping disciplines operating within a neoliberal theoretical framework and positivist epistemological paradigm using "biomedical explanatory modalities" (Kilty & Dej, 2018, p.2). The lack of explicit critical attention within the research to structural, contextual realities or the fluid complexity of identity (Khenti et al, 2019;Biringer et al, 2017), silences diverse experiences of violence within the psy-complex, falsely simplifying recovery as a universally accessible (or ideal) singular trajectory across difference (Peters, 2017) and in turn, privileges the neoliberal psy agenda (DeFehr, 2016;Rimke, 2016). In assimilationist epistemology, diversity is theorized as a "barrier to progress" (Hunter, 2002, p.125) in which the construction of a "successful immigrant" is defined according to assimilative principles and conformity to white rationality through "bootstraps discourse" (p.126), in which the assimilated immigrant is positioned as the knower.…”

Section: Mass Media and Psychocentrismmentioning

confidence: 99%

‘Such a white thing to do’: A discourse analysis of CAMH’s Coping with COVID-19 Campaign

Sullivan¹

2021

Preprint

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This major research paper is a modified critical discourse analysis of lived experience testimonials from the Centre for Addiction and Mental Health (CAMH)’s Coping with COVID-19 campaign. Social work practitioners and researchers must consider the inherent violence in the complex manifestations of sanism and racism (re)produced through discourse and their inextricable confluence with institutions, colonial legacies and realities which operate at this juncture in support of white supremacy. The identified discourses reproduce the ideal neoliberal subject and operate as technologies which maintain the colonial project and white supremacy. If we stake any claim to anti-racist praxis at this juncture, it is necessary to radically disclose our complicity within this colonial project, acknowledge our confluent realities and interrogate any claim to anti-racism. If we fail to interrogate these discourses constructing madness, we not only permit the violent trajectory of sanism but operationalize the deeply entrenched (re)production of violent white supremacy. key words: critical discourse analysis, sanism, racism, white supremacy, psychocentrism

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“…Critical mental health scholarship extending back to the 1950s documents misinformation, missing information, and potential for serious harm implicit within mainstream mental health and its disciplinary base of psychiatry (Bracken et al, 2012;Burstow, 2015;Cooper, 1967Cooper, /2001Foucault, 1954Foucault, /2011Goffman, 1961Goffman, , 1963Johnstone & Boyle, 2018;LeFrancois, Menzies, & Reaume, 2013). The critical literature also articulates a vast range of alternative ways of understanding and addressing the phenomena commonly classified as mental health issues (Anderson, 1997;Clark, 2016;DeFehr, 2016DeFehr, , 2017Foucault, 1954Foucault, /2011Linklater, 2014). Mental health promotion materials exclude critical scholarship thereby contributing to an illusion of disciplinary consensus.…”

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confidence: 99%

"Voluntarily, knowingly, and intelligently":

DeFehr¹

2020

Brock Education Journal

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Educators are part of in-school discussions about student mental health. At times, teachers may suggest that students consult with mental health professionals. Informed by mental health promotion resources, educator referrals to mental health professionals may lack discussion of critical mental health information. Mental health promotion materials do not acknowledge the extensive scholarly critique of mental health premises and practices. Much of this critique is produced within psychiatry, the disciplinary base of mental health. Critical scholarship discusses profound flaws, misinformation, and potential for harm within conventional mental health. Important critical mental health topics include scientific evidence, psychiatric drugs, and psychiatric diagnosis. Access to both critical and conventional mental health scholarship is necessary for students and parents to provide informed consent to mental health intervention. Some interventions commonly take place in the first meeting and therefore, students and parents need access to critical information prior to their first meeting with a mental health professional. Forming a critical mental health primer for teachers, this article goes beyond promotion of critical mental health awareness to call for institutional divestment from mental health premises and practices that cause harm and lack scientific, ethical, and intellectual integrity.

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Inventing Mental Health First Aid: The Problem of Psychocentrism

Cited by 31 publications

References 60 publications

A redesigned training and staff support programme to enhance job retention in employees with moderate-severe depression

A redesigned training and staff support programme to enhance job retention in employees with moderate-severe depression

‘Such a white thing to do’: A discourse analysis of CAMH’s Coping with COVID-19 Campaign

"Voluntarily, knowingly, and intelligently":

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