Doctoral‐Level Counseling Students’ Experiences of Social Class Microaggressions

The authors recruited 11 doctoral‐level counseling students to participate in a study exploring the lived experiences of people who have encountered social class microaggressions (SCMs). Findings (consisting of 6 themes) suggest that SCMs are a distinct phenomenon arising from interpersonal and environmental exchanges that damage recipients. The authors present implications for counselor education and future research trajectories

Contesting the psychiatric framing of ME / CFS

ME/CFS is a medically contested illness and its understanding, framing and treatment has been the subject of heated debate. This paper examines why framing the condition as a psychiatric issue—what we refer to as ‘psychiatrisation’—has been so heavily contested by patients and activists. We argue that this contestation is not simply about stigmatising mental health conditions, as some have suggested, but relates to how people diagnosed with mental illness are treated in society, psychiatry and the law. We highlight the potentially harmful consequences of psychiatrisation which can lead to people’s experiential knowledge being discredited. This stems, in part, from a psychiatric-specific form of ‘epistemic injustice’ which can result in unhelpful, unwanted and forced treatments. This understanding helps explain why the psychiatrisation of ME/CFS has become the focus of such bitter debate and why psychiatry itself has become such a significant field of contention, for both ME/CFS patients and mental health service users/survivors. Notwithstanding important differences, both reject the way psychiatry denies patient explanations and understandings, and therefore share a collective struggle for justice and legitimation. Reasons why this shared struggle has not resulted in alliances between ME and mental health activists are noted

“Catching your tail and firefighting”: The impact of staffing levels on restraint minimization efforts

Introduction: Safe staffing and coercive practices are of pressing concern for mental health services. These are inter-dependent and the relationship is under-researched. Aim: To explore views on staffing levels in context of attempting to minimise physical restraint practices on mental health wards. Findings emerged from a wider dataset with the broader aim of exploring experiences of a restraint reduction initiative Methods: Thematic analysis of semi-structured interviews with staff (n=130) and service users (n=32). Results: Five themes were identified regarding how staffing levels impact experiences and complicate efforts to minimise physical restraint. We titled the themes – ‘insufficient staff to do the job’; ‘detriment to staff and service users’; ‘a paperwork exercise: the burden of non-clinical tasks’; ‘false economies’; and, ‘you can’t do these interventions’. Discussion: Tendencies detracting from relational aspects of care are not independent of insufficiencies in staffing. The relational, communicative, and organisational developments that would enable reductions in use of restraint are labour intensive and vulnerable to derailment by insufficient and poorly skilled staff. Implications for Practice: Restrictive practices are unlikely to be minimised unless wards are adequately staffed. Inadequate staffing is not independent of restrictive practices and reduces access to alternative interventions for reducing individuals’ distress

Children and ADHD: seeking control within the constraints of diagnosis

The views of children diagnosed with ADHD have, until recently, largely been neglected in research, policy and practice. This article focuses on qualitative research which explored children's lived experience, drawing attention to the ways that they actively 'take' responsibility for managing their physical, psychological and emotional well‐being within the constraints of a medical diagnosis. The neglect of a tradition which asks children about their own experiences of ADHD is crucially bound up with children's low social and political status in UK society and notions of competency and responsibility in relation to ADHD

Poles apart: Does the export of mental health expertise from the Global North to the Global South represent a neutral relocation of knowledge and practice?

© 2015 Foundation for the Sociology of Health & Illness.The World Health Organization's Mental Health Action Plan 2013-2020 identifies actions for all member states to alleviate the global burden of mental ill health, including an obligation for mental healthcare to be delivered in a 'culturally appropriate' manner. In this article we argue that such a requirement is problematic, not least because such pronouncements remain framed by the normative prepositions of Western medical and psychological practice and their associated ethical, legal and institutional standpoints. As such, when striving to export Western mental health expertise, different paradigms for evidence will be necessary to deliver locally meaningful interventions to low and middle income countries. Our discussion highlights a number of philosophical concerns regarding methodologies for future research practice, including those relating to representation and exclusion in the guise of epistemic injury, presumptive methodologies arising from Western notions of selfhood, and related ethical issues

Poles apart: Does the export of mental health expertise from the Global North to the Global South represent a neutral relocation of knowledge and practice?

© 2015 Foundation for the Sociology of Health & Illness.The World Health Organization's Mental Health Action Plan 2013-2020 identifies actions for all member states to alleviate the global burden of mental ill health, including an obligation for mental healthcare to be delivered in a 'culturally appropriate' manner. In this article we argue that such a requirement is problematic, not least because such pronouncements remain framed by the normative prepositions of Western medical and psychological practice and their associated ethical, legal and institutional standpoints. As such, when striving to export Western mental health expertise, different paradigms for evidence will be necessary to deliver locally meaningful interventions to low and middle income countries. Our discussion highlights a number of philosophical concerns regarding methodologies for future research practice, including those relating to representation and exclusion in the guise of epistemic injury, presumptive methodologies arising from Western notions of selfhood, and related ethical issues

Too Young to Be Mad: Disabling Encounters with 'Normal' from the Perspectives of Psychiatrized Youth

In this paper, the psychiatrization of children and youth is explored, as well as their representation within Mad and Disability Studies. Presented are the outcomes of a photo voice project conducted with seven (N=7) youths between 14 and 17 years old constructed as having a “serious mental health issue.” The self-identified research question the young people asked and answered was: What is ‘normal mental health’ for children and youth? Through the photographs and explanations of the images, we learn that ‘normal’ is a matter of perspective, an ambiguous and shifting standard against which young people are compared, and from which constructions of ‘mental disorder’ as difference and abnormal are imposed on their experiences of distress. As a mechanism for psychiatrization, the difference becomes the rationale for prejudice and discrimination at the intersections of childhood and adultism, distress and sanism, and (in)competence and ableism. The implications of expanding children’s theorizing and activism for Mad and Disability studies are discussed

COVID-19 and Youth Living in Poverty: The Ethical Considerations of Moving From In-Person Interviews to a Photovoice Using Remote Methods

COVID-19 hit and instantaneously research using in-person methods were paused. As feminist and critical social work scholars and researchers, we began to consider the implications of pausing our ongoing project exploring the provisioning and resilience of youth living in low-income, lone mother households. Reflexively, we wondered how the youth, families, and issues we were connected to would be impacted by the pandemic. We were pulled into both ethical and methodological questions. While the procedural ethics of maintaining safety were clear, what became less clear were the relational ethics. What was brought into question were our own social positions and our roles and responsibilities in our relationships with the youth. For both ethical and methodological reasons, we decided to expand the original research scope from in-person interviews to include a photovoice to be executed using online, remote methods. In this article, we discuss those ethical and methodological tensions. In the first part, we discuss the relational ethics that propelled us to commit to expanding our work, while in the second part, we discuss our move to combining photovoice and remote methods. </jats:p