Modern pastors of mental health recovery: an ethnographic study of the recovery approach in Wales

The recovery approach is now a central tenet of mental health policy in the UK. Despite its ubiquity there is evidence of confusion over its meaning and practice. In addition, recovery is accused of being a new iteration of neoliberalism with a focus on self-responsibilisation. Drawing on historical, ethnographic and discursive research conducted within mental health services in South Wales, this thesis explores how the contemporary recovery approach to mental health has arisen, how practitioners and service users enact it and the challenges and tensions that arise in practising in this way. The study draws on Foucauldian ideas of power and knowledge, with a focus on the role of language in recovery practices. The historical study showed how a range of past approaches to mental health are reflected in the contemporary recovery approach and explored how these approaches gained the power to define how recovery has been understood over the last few centuries. The ethnographic findings show that practitioners of different professions work to a consistent version of recovery, focussing on ‘what works’ and promoting service user responsibilisation. Practitioners facilitated recovery through the use of pastoral power and specific discursive strategies. Service users exercised agency in aligning with or rejecting the recovery discourse and the process of engendering recovery subjectivities in service users was complex, unpredictable, and sometimes unsuccessful. I draw on Hacking’s (1996) work on looping effects to show how professionals’ categorisations of service users had important consequences for the service they received. In considering recovery as a neoliberal solution to mental health problems, the study highlights the complex assemblages of people, policy, practices, laws and emotions that constitute recovery practice and concludes that in the field of neoliberal rationalities, recovery appears to be struggling to fulfil its programmatic aspirations and goals