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Risk, trust and the myth of mental health services
- Authors:
- VASSILEV Ivaylo, PILGRIM David
- Journal article citation:
- Journal of Mental Health, 16(3), June 2007, pp.347-357.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Strictly "mental health" should, as its name suggests, be about health, yet there is now a global discourse about "mental health" which actually alludes mainly to the clinical, organizational and legal aspects of managing mental disorder. Indeed, "mental health" law deals with the conditions under which people diagnosed with mental disorder can be lawfully compelled to accept treatment. This paradoxical use of language requires further examination. The paper aims to problematize the taken for granted notion of "mental health services". It draws upon general sociological work on "risk" and "trust". The trustworthiness of ordinary language accounts and professional codifications are considered before examining the sociological implications of the controversy about the abuse of psychiatry. The risks to and from patients in routine mental health work, and the betrayal of trust as both a normal part of care and its corruption in mental health work are outlined. The paper concludes that "mental health services" are a myth in as much as they are mostly concerned with mental disorder and control (at least to the bulk of identified patients which form the focus of their activity).
Mental health policy and the politics of mental health: a three part tier analytical framework
- Authors:
- PILGRIM David, ROGERS Anne
- Journal article citation:
- Policy and Politics, 27(1), January 1999, pp.13-24.
- Publisher:
- Policy Press
This article offers a broad unifying analytical framework which includes this range and variety while bringing some order into a field which can overwhelm individual scholars. The framework has three tiers: macro, meso and micro. These refer respectively to global and transhistorical factors; national and cultural factors; and local and personal factors. A case study is outlined (mental health, violence and coercion) to illustrate the utility of the framework. Its advantages and limits are then discussed in relation to interdisciplinarity and transdisciplinarity.