A social construction of remission for people with a diagnosis of schizophrenia

DOIhttps://doi.org/10.1108/MHSI-02-2018-0009
Pages94-107
Published date09 April 2018
Date09 April 2018
AuthorKeith Ford
Subject MatterHealth & social care,Mental health,Social inclusion
A social construction of remission for
people with a diagnosis of schizophrenia
Keith Ford
Abstract
Purpose The purpose of this paper is to provide a social construction of remission in relation to
schizophrenia by the people affected most. The qualitative perspective utilised is a contrast to the majority of
papers around, which have been quantitative when addressing the concept of remission for people with a
diagnosis of schizophrenia. This paper acknowledges and demonstrates evidence of listening to the
stakeholder groups affected by the issues associated with remission and recovery, and delivers clarity around
the phenomena of remission in relation to recovery.
Design/methodology/approach A constructivist grounded theory approach was employed, exploring
participantsinterpretation of the concept of remission in schizophrenia. A purposive sample, of nine
professionals, ten service users and seven carers, was recruited from two community mental health teams in
the UK. Semi-structured interviews were employed to yield the data and all interview transcripts were
analysed utilising qualitative codesthereby defining what is seen in the data. Diagramming and concept
mapping was employed. Theoretical sensitivity was applied to demonstrate remission in abstract terms and
to illustrate the openness, transparency and intention of the study.
Findings The findings resulted in a conceptual map of the themes generated from the data. From this map
four possible trajectories were developed, each highlighting a route which could be taken and the issues
faced along the way. Positive and negative aspects of the trajectories offer discussion points for service users
and practitioners alike to consider in their professional relationship. In addition a representation of the current
interplay between recovery and remission is highlighted to offer clarity in relation to present service provision.
Research limitations/implications The perspective and opinion from practitioners in Primary Care
services was not proposed or included within this study. To gain an improved and realistic insight into this
perspective a range of practitioners from primary care could provide valuable data for any future study as this
would prove to be a valuable enhancement. This study offered a broad overview of professional groups with
the ability to discuss mental health services, although it did not allow for a concentration from specific
professional groups and therefore they were not able to fully represent their professional group.
Practical implications This paper has illuminated the area of remission for people with schizophrenia and
will therefore have practical implications in respect of on-going service development. In particular the interface
between primary and secondary services which have struggled to employ consistent terminology serving
only to confuse service users and service providers alike. The trajectories illustrated in this study offer clarity
and understanding and direction for improved practice to facilitate recovery for people with a diagnosis of
schizophrenia. Shared understanding of concepts between service users and providers could be a large
move in a positive direction.
Social implications The movement of people formerly diagnosed with schizophrenia from secondary
mental health services back to primary care may have huge social implications. Resistance, stigma and
ignorance play a large part in services having toretain people within secondary mental health services.
Misunderstandings around diagnosis, and terms such as remission and recovery fuel such confusion
resulting in a risk averse position for most. This study clarifies some of the issues in relation to the transition
back to society and citizenship for people and offers scope for further research of a qualitative nature too.
Originality/value Previous studies around the concept of remission for people with a diagnosis of
schizophrenia have centred on medication efficacy, utilising remission criteria to determine changes in
symptomolotolgy. These quantitative papers have not addressed service users, carers or practitioners
in healthcare in relation to their understanding of the term remission, in relation to recovery; or whether they
feel it would be of use in clinical practice. This study addressed those issues gaining valuable in-depth data
from participants, deriving the social construction of remission and the impact it may have in clinical practice
in a non-pathologising perspective.
Keywords Qualitative research, Recovery, Schizophrenia, Remission
Paper type Research paper
Keith Ford is a Senior Lecturer
at the Department of Nursing,
Fatima College of Health
Sciences, Ajman,
United Arab Emirates.
PAG E 94
j
MENTALHEALTH AND SOCIAL INCLUSION
j
VOL. 22 NO. 2 2018, pp. 94-107, © Emerald Publishing Limited, ISSN 2042-8308 DOI 10.1108/MHSI-02-2018-0009

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