Mental health and reflexivity: The role of personal experiences of mental ill-health in medical sociological research

Blog co-authored with Tineke Broer, University of Edinburgh

bale-191199_1280

Reflexivity is framed as an important aspect of rigorous sociological research. Critically reflecting on the position, role and influence of the researcher, and how this shapes the knowledge they create, provides a way of navigating epistemological threats to research practice. Sociological (and anthropological) research on mental ill-health has – for some researchers – entailed drawing productively on personal experiences. This is seen in Jackie Orr’s (2006) study of panic, subtitled ‘a genealogy of panic disorder’. She draws explicitly on her own experiences of panic and of participating in a clinical trial, critically considering her experiences in the light of a normalizing and in some ways disciplining psychiatry. Similarly, anthropologist Emily Martin (2009) uses her experiences of manic depression as a source of data, and a way in, to a wider ethnography of depression in the US.

More directly, ‘mad studies’ and user-led mental health research contributes to debates about the impact of experience on research and knowledge production. Standpoint epistemology in mental health research and mad studies has offered further ways of thinking through and with subjective experiences understood by one’s self or others as pathological (Rose 2003; LeFrançois, Menzies, and Reaume (Eds) 2013). This re-positions and reconfigures experience within a research context; and this movement can in part be seen as a reaction against power imbalances in psychiatry. There are, then, significant political implications to methodological and theoretical reflections on reflexivity.

These political aspects are evident in Alain Ehrenberg’s (2009) work, which argues that ‘admitting’ one’s mental ill-health in a public place relies on and constructs a particular notion of the self: one that confesses its disturbances in order to promote a social cause. Thus, conceptualisations of knowledge (production) and those of selfhood are intricately linked, and are reflected in the way in which researchers use (or do not use) experiences of mental ill-health in their research.

In a forthcoming symposium, funded by the Foundation for the Sociology of Health and Illness, we aim to provide space to critically interrogate the role of personal experience of mental ill-health in medical sociological research. What are the implications of researchers’ experiences with mental health when they set out to investigate sociological aspects of mental ill-health? What are the risks and benefits of researching experiences which may be close to our own? Are there dangers in researching experiences which we cannot share? What does it mean to draw on our own experiences when writing up the research, or when the research draws almost exclusively on our own experiences such as in auto-ethnography? Reflecting on these issues raises important wider debates regarding the nature of knowledge and the world.

The symposium will be held on 7th of June 2016, and aims to explore in depth what it means to draw upon one’s own experiences of mental ill-health in sociological knowledge production. The two confirmed speakers are Professor Diana Rose and Professor Dave Pilgrim. Diana Rose is Professor of User-Led Research, King’s College London, conducting research in her identity as (former) service user. Dave Pilgrim is Professor in the School of Social Work, University of Central Lancashire, and is co-author (with Anne Rogers) of the book A Sociology of Mental Health and Illness.

There are several spaces for papers from other researchers working on mental health, who would like to contribute reflections, analysis or findings relevant to the topic of reflexivity in mental health research. We are especially interested in hearing from sociologists, but welcome those working in other relevant disciplines (psychology, social work, anthropology, STS).

Details about abstract submission can be found here. Deadline for abstract submission is 6th March 2016.

Registration for the event is open, follow this link.

Organising committee: Tineke Broer (University of Edinburgh), Amy Chandler (University of Lincoln) and Martyn Pickersgill (University of Edinburgh). This symposium is generously supported by funding from the Foundation for the Sociology of Health and Illness.

References

Ehrenberg, A. (2009). Weariness of the Self: Diagnosing the History of Depression in the Contemporary Age. McGill-Queen’s Press.

LeFrancois B.A., Menzies R. & Reaume H., eds (2013) Mad Matters: A Critical Reader in Canadian Mad Studies. Canadian Scholars’ Press Inc., Toronto.

Martin, E. (2009) Bipolar Expeditions: Mania and Depression in American Culture. Princeton University Press

Orr, J. (2006). Panic diaries: a genealogy of panic disorder. Duke University Press.

Pilgrim, D. and A. Rogers (2010). A Sociology of Mental Health and Illness. Open University Press.

Rose, D. (2003). ‘Having a diagnosis is a qualification for the job’. BMJ. 2003 Jun 14; 326(7402): 1331.

Advertisements

Personal troubles and public issues: Suicide among disadvantaged men in mid-life and the importance of sociology

Suicide and society

BBC Newsnight ran a story on 5th March 2013 exploring the reasons why men in the UK are around three times more likely to complete suicide than women. As well as gender, other social factors affect suicide rates, particularly age and socio-economic position. While suicide is the leading cause of death for men aged 30-44, the suicide rate among men aged 45-59 has been “increasing significantly” since 2007 (ONS 2013) becoming almost equal to the 30-44 year old rate. The group of men most likely to die by suicide is men in mid-life (aged 35-54) in the lowest socio-economic group, a fact highlighted in a report published by Samaritans last year.

The Newsnight programme featured the work of both Samaritans and CALM (The Campaign Against Living Miserably), as well as including powerful testimony from men who had experienced suicidal thoughts, and the family of a man who had completed suicide. Much of the discussion focused on the difficulties faced by men in acknowledging distress and seeking help. Barriers include ‘masculine’ ideas about appropriate behaviour, especially around communicating about distress; the design of mental health services; and wider stigma about mental ill-health. In light of these barriers, it was heartening to see suicide among men discussed so openly and in such a public setting. It was encouraging also to see the involvement of a range of professionals, perspectives and views.

What the programme also showcased (albeit not explicitly) was the importance of sociological perspectives in contributing to understanding suicide. The discussion demonstrated the extremely wide-ranging factors that impact on suicide among men including: economic hardship, changing labour markets, relationship breakdown, drug and alcohol use, socially proscribed expectations of what men and women should do, as well as mental ill-health. Many of these issues are explored in detail, using sociological approaches, in a report from Samaritans, which I contributed to: Men, Suicide and Society (2012). The report argued that the complex nature of suicide necessitates wide-ranging attempts at explanation, which go beyond clinical or psychiatric perspectives which – while important – have historically dominated suicidology.

Suicide research, policy and practice should incorporate a similarly wide disciplinary lens; and suicide prevention strategies too need to be wide-ranging. Although suicide is very much a ‘personal trouble’ it is also an inherently ‘public issue’ (Mills 1959). As such, policy and practice in a range of areas can and do impact on suicide. It already appears that the current economic climate is impacting negatively on rates of suicide, particularly among men living in areas with high rates of unemployment (Barr et al., 2012). These ‘public issues’ will not be solved by improvements in mental health services alone; but require bolder action in terms of addressing gender inequalities and gendered expectations of men and women, tackling socioeconomic inequalities, reducing social isolation, and improving the chances that men and women have of living fulfilled and content lives.

References and Resources

Barr, B., Taylor-Robinson, D., Scott-Samuel, A., McKee, M. and Stuckler, D. (2012), ‘Suicides associated with the 2008-10 economic recession in England: time trend analysis’, BMJ, 13, 345.

Mills, C. W. (1959) The Sociological Imagination New York, Oxford University Press

ONS (2013) Suicides in the United Kingdom 2011

Samaritans (2012) Men, Suicide and Society, why disadvantaged men in mid-life die by suicide