Open to Suggestion: Ordering, Risk and Invention in Community Mental Health Work

Stronge, Paul. 2010. Open to Suggestion: Ordering, Risk and Invention in Community Mental Health Work. Doctoral thesis, Goldsmiths, University of London [Thesis]

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Abstract or Description

Accounts of contemporary mental health policy and practice are contested and diverse. Yet they tend to share an implicit ontological commitment to a logic or 'register' of specialism. That is, they fundamentally assume the existence of a range of professional and disciplinary activities designated by 'mental health work' may be unproblematically divided off from other areas of social activity and relations.

In this thesis I contrast the register of specialism to a register of suggestion. Firstly, this notion evokes comparatively neglected aspects of the histories that condition present-day practice. More importantly, making primary recourse throughout the thesis to the work of A.N. Whitehead as inspiration and lure, I argue that suggestion offers a fertile conceptual device that problematises subject-predicate modes of thought underpinning 'specialist' accounts. Moreover my approach opens up inter-connections and contingencies between mental health work and the affective as well as socio-technical dimensions of everyday life.

The thesis draws on empirical material gathered during a six-month ethnographic study of a multidisciplinary Community Mental Health Team in London. Using the contrast between suggestion and specialism as a key conceptual device I focus on team members' experience of risk and of the tension between crisis and routine and on the ways in which they participate in the constant reconfiguration of order within their day-to-day work. I will argue that regarding workers as constantly and fundamentally 'open to suggestion' not only allows otherwise neglected and creative aspects of practice to emerge to the fore. It also raises important methodological and epistemological questions concerning processes of social change and (insofar as adoption of the register of suggestion bears implications for the notion of an ethnographic sensibility) for the enterprise of social research itself.

Thus the thesis reaches beyond the remit of mental health work as conventionally interpreted. It resonates with established and contemporary controversies within social theory around methodological challenges and limitations and within the sociology of health and medicine around the nature of therapeutic change. It is posited simultaneously as directly relevant to practitioners and policy-makers working in the mental health field and as an intervention in these ongoing social-theoretical debates.

Item Type:

Thesis (Doctoral)

Identification Number (DOI):

https://doi.org/10.25602/GOLD.00028956

Keywords:

mental health, policy, practice, register of suggestion, A.N. Whitehead, ethnographic study, social theory

Departments, Centres and Research Units:

Sociology

Date:

2010

Item ID:

28956

Date Deposited:

06 Jul 2020 13:35

Last Modified:

08 Sep 2022 12:49

URI:

https://research.gold.ac.uk/id/eprint/28956

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