Social representations and professional knowledge: The representation of mental illness among mental health practitioners

Abstract

The closing decades of the twentieth century saw a dramatic shift from institutional to community-based care for the mentally ill. This paper describes a study of the social representation of mental illness by mental health professionals working in Britain and France during this time of major policy change. Such professionals play a vital social role in translating policy directives into practical work with laypeople, yet their representations are relatively under-researched. Data in this study derive from semistructured interviews on the nature of mental ill-health and mental health work conducted with a multidisciplinary sample of professionals (N=60). Consonant with community care policies, analysis suggests that professionals conceptualize mental ill-health and its treatment in social rather than medical terms. However, uncertainty characterizes many aspects of their representations. This is associated with eclectic working practices combining multiple strategies derived from diverse theoretical traditions. The changing policy context appears to have augmented this representational uncertainty. Psychodynamic perspectives are more influential amongst French practitioners compared with their British counterparts. The study highlights how social representations held by 'intermediary' groups reflect their interface between scientific and lay spheres. The role of power and the function of social representations in reconciling sources of tension and ambiguity associated with this unique social position are discussed.

Mental ill health in the elderly: medical students’ social representations in the United Kingdom

“…Research on social representations on mental health has identified them as an "intermediate group", positioned between "expert" and "lay" systems of knowledge (12) . Progression in medical clinical school has been associated with more contact with expert knowledge and less stigmatizing ideas and practices on mental health (21) .…”

“…On the other hand, societal conceptions do not only reflect negative representations of mental health in later life. Current trends in psychosocial management of mental health and public policies focusing on active ageing represent ideological attempts to present positive theory and praxis in health services (12,13) .…”

“…Previous findings show that social groups still perceive the "mentally ill" as different and dangerous (18)(19)(20) . Mental health professionals also tend to share these representations (12) . Disqualifying representations of ageing and mental illness might constitute some of the barriers to promoting social and political changes in mental health care (9) .…”

“…The lack of clear understandings about the nature and consequences of mental illnesses also contribute to discriminatory practices in the general population (12,19) . …”

“…This eclecticism of care might reveal attempts to incorporate a psychosocial framework into traditional forms of care (9,12) .…”