Shared dilemmas, choice and autonomy in the management of psychosis: a phenomenological analysis

Abstract

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -When detaining and enforcing treatment, psychiatric services often assumed that the person is separate from their dysfunctional biology and removed from their social context. Coproduction is hindered by polarised views where one party holds power and others are not able to promote their views. But if biomedical models are abandoned, ethical grounding for mental health law would be lost. The purpose of this paper is to explore the experience of detaining and being detained, clarifying understandings of trust, illness, personhood and control. Design/methodology/approach -A hermeneutic phenomenological approach was employed. Findings -A Social Worker and man who suffers from psychosis report that their choices are limited by mental health law. They both experience themselves as passive. The man rejects society and withdraws to avoid stress; while the Social Worker just follows legal guidelines. Interaction in mental healthcare is experienced as lacking trust, involving threat, but sometimes negotiation is possible. Control over illness is associated with having a choice of treatments. Psychosis is not experienced as a separate illness process and control is exercised over the person rather than that illness. Research limitations/implications -This was a small qualitative study designed to prompt discussion and inform further research and policy review. Practical implications -To enable coproduction, detention or enforced treatment should be grounded more firmly in morality or criminal justice. Social implications -People who suffer psychosis could be understood and their views more often accepted. Originality/value -An innovative research approach is used to bring new understanding.

Do people choose to be homeless? An existentially informed hermeneutic phenomenological analysis

“…People will not trust others or seek fulfiling roles in society if their human responses are treated as meaningless; as madness. It would be better if the use of mental health law were limited to criminal justice and moral concern, rather than extended to control people who are uncomfortable reminders of society's neglect (Wharne, 2015). Homeless populations are not just a technical problem to be solved.…”