The power of language in mental health settings: A Foucauldian Discourse Analysis of clinician-service user interaction and implications for psychological practice

Abstract

When a person accesses support for their mental health is their behaviour 'help-seeking' or 'attention-seeking'? Does an individual 'fail' or 'survive' a suicide attempt? Survivor-led narratives of individuals with lived experienced of the mental healthcare system denote how language that is used by the professionals in their lives appears to have the power to inspire resilience and recovery, or to stigmatise and discourage engagement from psychological services altogether. However, despite its demonstrated impact, little research explores how oppressive discourse regarding mental health have developed and how they are utilised in mental health care practice. This research focused on the impact of language used by mental health professionals utilising a Foucauldian Discourse Analysis of transcripts of hidden-camera footage showing interactions between mental health professionals and service users in an NHS inpatient mental health unit. The footage was taken from the BBC's Panorama documentary - Undercover Hospital: Patients at Risk, originally aired September 2022. The study of this phenomenon, and the insight it can provide into the impact of power dynamics in psychological practice, is essential knowledge within any school of psychotherapy or mental healthcare practice. This research aimed to deepen the understanding of language representing systemic power imbalances. It also aimed to identify encouraging, collaborative language, that has demonstrated positive impacts in service users' care. A further aim was to determine implications and develop guidance for mental health care practitioners regarding language use and social justice in practice. This is a qualitative study adhering to a social constructionist epistemology and a relativist ontology. The analysis indicated a normalisation of oppressive discourse has developed in mental health facilities, which includes the minimisation of distress, constructions of service users as problematic, normalisation of punishment and punitive practice, and the development of abusive regimes of physical practice developing from stigmatising discourse. The analysis also revealed powerlessness experienced by staff and service users within a mental health care system which reflects the inequalities and injustices experienced in wider society. Implications and recommendations for mental health care practice which promotes social justice through language are provided and discussed.

Date of Award	1 Aug 2024
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Jo Shuttleworth (Supervisor) & Erica Burman (Supervisor)