From psycho-politics to mad studies: learning from the legacy of Peter Sedgwick

We now have a new kind of psycho-politics; a brutal and destructive alliance between neoliberalism and an expanding psychiatric empire. This article will explore how mental health service users/ survivors and other mental health campaigners can connect with the critical analysis and action embodied in the work and values of Peter Sedgwick at a time of crisis and reaction. They have seen ideas like 'user involvement' and 'recovery' co-opted and undermined, and both their experiences and aspirations individualised and devalued. Emerging interest in mad studies, it is suggested, offers a way forward that challenges both the marketisation and medicalisation of people's distress. This discussion will explore the continuities and discontinuities with Peter Sedgwick's pioneering work and highlight, as he did, the importance of making explicit the political and ideological relations of survivors' struggles within and against the psychiatric system

Mend the gap – strategies for user involvement in social work education

A major strand in social work’s history has been its paternalistic character, partly due to a philanthropic tradition, but also to the tendency to import an individualist expert model into social work practice. As a result, gaps have arisen between expert and experiential knowledge. In this article, so called ‘gap mending strategies’ developed by the international network PowerUs are discussed. PowerUs consists of teachers and researchers from schools of social work and representatives from service user organizations in nine European countries. The gaps as the network identifies them are presented and we share some processes within our practices that mend or maintain gaps between service users and professionals. Two main strategies will be explored in more detail—a strategy that has been developed in the UK of mainstreaming service user participation in all stages of social work education, and a strategy that has been developed in Scandinavia of developing joint courses for social work students and students from service user organizations. A main conclusion is that alliances between educational institutions and service user organizations will be important to get a fuller understanding of what gaps we are facing and how they best could be mended

Public Participation in Health and Social Care: Exploring the Co-production of Knowledge

Efforts to advance public participation in health and other policies have been associated with the production of many models and how-to-do-it guides for change. While these may have a helpful part to play in improving public and patient/user involvement in research, in this article it will be suggested that they tend to over-simplify things. Instead it is argued that an essential first step to advancing public participation in health is to put it in the context of developing modern democracy more generally. This article will seek to do this by identifying four key stages in the development of public participation in health and social care. These phases will be headlined as: - Working for universal suffrage in representative democracy and the achievement of social rights, like the right to decent housing, education and health;- Provisions for participatory democracy and community development;- Specific provisions for participation in health and social care;- State reaction and service user-led renewal as conflicts and competing agendas develop.While the proposed article will look particularly at UK developments to do this, it will also draw upon international experience and highlight the wider relevance of these phases of development. It will make connections between the extension of representative and participatory democracy, considering the different locations in which efforts to extend participation have helpfully developed, for example, in learning and training, and research and knowledge production. It will also consider how efforts to extend participation have also been undermined by pressures to tokenise and co-opt them; the continuing barriers discriminating against some groups and, ways in which service users and allies have nonetheless sought to overcome these difficulties to take forward more inclusive and diverse participation in health and social care. It will focus on some particularly promising areas of development internationally in order to do this in which co-production and the development of user-led knowledge are key

A socio-technical transitions perspective for assessing future sustainability following the COVID-19 Pandemic

This policy brief argues that the COVID-19 pandemic exposes the fractures in the contemporary global socio-technical order and offers the prospects of several different alternative futures. The policy brief explores the pandemic through the lens of the multi-level perspective on socio-technical transitions. The pandemic is framed as a meta-transition event at the landscape level of unprecedented scale, pace, and pervasiveness such that it permeates all socio-technical regimes simultaneously. The prospects for the future are then defined on a matrix that compares the strength of civil society and that of economic structures. The result is four distinct scenarios that are linked to contemporary discourses on socio-economic futures: business as usual; managed transition; chaotic transition; and managed degrowth. The scenarios are presented as a starting point for policy discussion and the engagement of societal actors to define social and economic possibilities for the future, and the implications that the different futures would have for ecological burdens. It is concluded that the COVID 19 pandemic can act as a catalytic event in which the legitimacy and efficacy of existing economic and political structures will be challenged and reshaped, and hence is an opportunity to redefine the ecological burdens our activities create

Decolonising global mental health: The role of Mad Studies

In recent years, there has been a growing and high-profile movement for ‘global mental health’. This has been framed in ‘psych system’ terms and had a particular focus on what has come to be called the ‘Global South’ or ‘low and middle-income countries’. However, an emerging ‘Mad Studies’ new social movement has also developed as a key challenge to such globalising pressures. This development, however, has itself both being impeded by some of the disempowering foundations of a global mental health approach, as well as coming in for criticism for itself perpetuating some of the same problems as the latter. At the same time, we are also beginning to see it and related concepts like the UNCRPD being given new life and meaning by Global South activists as well as Global North activists. Given such contradictions and complexities, the aim of this paper is to offer an analysis and explore ways forward consistent with decolonizing global mental health and addressing madness and distress more helpfully globally, through a Mad Studies lens

Semantics of patient choice: how the UK national guideline for depression silences patients

Several stakeholders, including the National Survivor User Network and the British Psychological Society, have called for the National Institute for Health and Care Excellence (NICE) to include an up-to-date review of patient experience research in the new depression guideline. In response, the Guideline Committee (GC) postponed publication, the guideline now due in February 2020. Yet the GC also stated it will not review patient experience research. Instead, it will incorporate a new element of ‘patient choice’, without elaborating what this entails. Here, we attempt to untangle a number of similar sounding terms including ‘patient choice’, ‘patient preference’, ‘patient experience research’ and ‘service user involvement’ in terms of how they relate to the NICE depression guideline. We argue that by conflating these concepts and implying that one will serve the purpose of another equally well, NICE risks leaving patients without a real voice, their perspectives buried in semantically void rhetorical jargon

Marginalised or enabled voices? 'User participation' in policy and practice

The idea of participation has been central to many policy developments in recent years. Both Conservative and Labour governments have used notions of participation and involvement in attempts to justify and implement their social policies. Yet, despite a plethora of initiatives and guidance around ‘participation’ emerging from all levels of government, and a substantial academic literature, there remains a major, and potentially damaging, lack of clarity over many aspects of participation, while the secret of achieving ‘real’ participation appears to continue to remain elusive