Barnes H 'Theory, evidence-base and critical reflection on mental health and social exclusion. Using evidence-base in professional practice'.

Current policy on evidence-based practice emphasises experimental evidence-base regarding the effectiveness of interventions. Critiques of this approach from service user and professional perspectives are gaining ground, with increasing valuation of user-led research, reflective practice and use of a range of research methods. Critical and emancipatory approaches point also, however, to the importance of questioning and rethinking fundamental assumptions about the causes of health and social care problems, for it is these which inform the broader use of particular interventions and knowledges. These assumptions, often the legacy of earlier historical periods, can be discriminatory or at best irrelevant to users. Rethinking them involves a wide-ranging and in-depth exploration of the issues users face, as a basis for more effective and user-centred responses. This search for new understandings to inform practice involves a particular use of evidence-base, drawing upon research employing the range of methods and engaging with all perspectives to explore the processes involved in users’ concerns. The result of this is to tell a ‘different story’ about users’ concerns and hence what may be helpful in addressing them. The paper therefore seeks to ‘tell a different story’ about mental health and social exclusion to that emphasised in policy today, and explore implications for helpful responses.