A Place for Healing in Mental Health Care and Recovery

Abstract

This research utilises an autoethnographical approach to explore aspects of place that facilitate healing in mental health care. The work challenges the dominant paradigm of evidence based medicine, and its hierarchy of evidence which diminishes the value of the voice of experience. Autoethnography provides representational space to explore my plural and sometimes contradictory voices as service user, psychiatrist and researcher. Foregrounding my personal experience, in dialogue with that of 10 other service users, the data comprised historical writings (mine) and in-depth individual interviews, which were analysed thematically. Descriptions of place were contextualised, with accounts of what it was like to be unwell and then how that changed, providing a way of understanding how place is implicated in healing. Mental illness is experienced as an existential disruption characterised by disconnection, fragmentation and suffering. Healing, understood as the intensely personal experience at the heart of recovery, is conceptualised as a journey of exploration that is hard work and takes time. Facilitating connections, we developed understanding; with time and practice, we integrated our hard earned wisdom, developing meaning and becoming whole: our suffering was transformed. A place that was healing was one that provided safe haven; metaphorically holding us in a collaborative environment of care, hope and trust, while creating space and opportunities to develop and test the connections that underpinned healing. Opportunities place the possibility with the explorer, implying we are not passive (or even active) recipients of care; rather we are active participants, creating or making use of the multifarious opportunities available to us. More than the physical location and the people and structures within, place is an accumulation of interacting experiences. On these journeys of exploration we come to know places inside and out: redrawing our internal landscapes these places come to reside within us, integrated into our sense of ourselves. Exploration of the subjective experience of illness and place offers the potential to better understand and inform service delivery and development. This thesis ends with reflections on the multivocality of autoethnography, and its potential extrapolation to multiperspectival contributions to wiser mental health care.