Exploring the case for truth and reconciliation in mental health services
| Date | 12 June 2017 |
| DOI | https://doi.org/10.1108/MHRJ-01-2017-0011 |
| Pages | 83-94 |
| Published date | 12 June 2017 |
| Author | Helen Spandler,Mick Mckeown |
| Subject Matter | Health & social care,Mental health |
Exploring the case for truth and
reconciliation in mental health services
Helen Spandler and Mick McKeown
Abstract
Purpose –The purpose of this paper is to explore the case for a truth and reconciliation (T&R) process in the
context of mental health services.
Design/methodology/approach –The approach is a conceptual review of T&R approaches; a
consideration of why they are important; and how they might be applied in the context of mental
health services and psychiatry. First, the paper sets out a case for T&R in psychiatry, giving some recent
examples of how this might work in practice. Then it outlines potential objections which complicate any
simplistic adoption of T&R in this context.
Findings –In the absence of an officially sanctioned T&R process a grassroots reparative initiative in mental
health services may be an innovative bottom-up approach to transitional justice. This would bring together
service users, survivors and refusers of services, with staff who work/ed in them, to begin the work of healing
the hurtful effects of experiences in the system.
Originality/value –This is the first paper in a peer-reviewed journal to explore the case for T&R in mental
health services. The authors describe an innovative T&R process as an important transitional step towards
accomplishing reparation and justice by acknowledging the breadth and depth of service user and survivor
grievances. This may be a precondition for effective alliances between workers and service users/survivors.
As a result, new forms of dialogic communication and horizontal democracy might emerge that could sustain
future alliances and prefigure the social relations necessary for more humane mental health services.
Keywords Mental health services, Epistemic injustice, Psychiatric harm, Psychiatric survivor movement,
Transitional justice, Truth and reconciliation
Paper type Conceptual paper
Introduction
This paper explores the case for organising a reparative truth and reconciliation (T&R) process in
mental health services and systems. For the purposes of this paper, we refer to “psychiatry”and
“mental health services”interchangeably as a whole set of related practices in which mental
health professionals are involved. This includes the medical speciality of psychiatry which is the
dominant perspective in mental health services and frames statutory mental health systems.
T&R would involve bringing together service users, survivors and refusers of services, with the
staff who work/ed in them, to begin the work of healing the hurtful effects of experiences in
the system (Slade, 2009; Wallcraft and Shulkes, 2012; Spandler, 2016b; McKeown, 2016).
We see this as part of a wider project concerned with challenging, reforming and transforming
mental healthcare. In the absence of any officially sanctioned T&R process, we outline a
grassroots initiative which could bridge towards constructive alliances between workers, service
users and survivors.
We have been involved in various mental health movements, predominantly as allies of
psychiatric survivors/service users, and have reflected upon the value of such conjoint activism
(e.g. Cresswell and Spandler, 2013; McKeown et al., 2014). However, we have been frustrated
with tendencies for polarisation and splitting which can derail progress by oversimplifying
complexity, stifling debate and preventing further exploration and mutual understanding of
different perspectives.
Received 29 January 2017
Revised 13 February 2017
27 April 2017
Accepted 28 April 2017
Helen Spandler is a Reader
in Mental Health at the
Department of Social Work,
Care and Community,
University of Central
Lancashire, Preston, UK.
Mick McKeown is based at the
School of Nursing, University of
Central Lancashire, Preston, UK.
DOI 10.1108/MHRJ-01-2017-0011 VOL. 22 NO. 2 2017, pp. 83-94, © Emerald Publishing Limited, ISSN 1361-9322
j
MENTALHEALTH REVIEW JOURNAL
j
PAG E 83
To continue reading
Request your trial