ACAP Alumna Kara Holmes Presents at Oxford

Posted by ACAP on 18 December 2013

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Congratulations on presenting your paper ''You can’t put it in a box and tie it with a ribbon': The consumer movement and the social construction of mental illness' at the 6th Interdisciplinary Conference on Madness at Mansfield College, Oxford. How did this come to be?
My supervisor Dr Fiona Ann Papps and I responded to a call for papers by for the 6th global conference on Madness.  This involved reducing my Honours thesis down to 3000 words, and making a submission that was fortunately selected for presentation.

In your paper, you say that professionals construct mental illness through institutions, while consumers do not, and that this is apparent in the language the two groups use…
Absolutely. Professionals in my sample constructed mental illness using psychiatric jargon. They also referred to the social practices of the institution to manage demand for resources; standardised risk assessments, checklists, and fulfilment of their roles in the system.  Professionals’ constructions were almost void of any reference to philosophical, spiritual, and other meaning-making discourses to explain mental illness. For professionals, mental illness is a pathology to be eradicated.

For consumers, mental illness is meaningful and is grounded in their experience of the world, of themselves, and of others.  Unlike professionals, consumers did not make sense of mental illness by constructing the social practices of the institutionalised system of mental health care.

How does this affect the way consumers and professionals communicate and negotiate?
It seems consumers are often complicit in meeting the needs of the institutional order.  For example, a professional uses a standardised questionnaire to obtain information from a consumer. Dialogues based on standardised questionnaires are a social practice that has become institutionalised. The professional says to the consumer “now, some of these questions might seem odd or unusual, but these are questions that we have to ask everyone”.  The consumer then invariably agrees to participate in a standardised dialogue.
What we see here in language is the professional constructing compliance with the institutions’ need for information, thus reducing personal agency.  The consumer’s co-operation in a one-size-fits-all dialogue positions the consumer as complicit in assisting the professional to meet the needs of the institution.  The cost for the consumer is that they are de-centred in this process.  Furthermore, if a consumer were to ask odd or unusual questions that were inappropriate to the situation, the professional would frame these up as pathological “symptoms” of a “disorder”.

What was that like to present at Oxford?
It was very exciting to spend three days engaging with a group of academics and professionals from all over the world who share my interest and curiosity about the construction of madness, and who also shared my willingness to undermine the familiarity of the present in order to take a look at ourselves and our society. Delegates were from varied disciplines including criminology, law, philosophy, social work, psychiatry, psychotherapy, literature, and education.  Sharing my research with a group of people who were interested in discovering the perspectives of people from fields different from their own was an absolute pleasure. Both the atmosphere and the dialogue were creative and unique in that it felt as though each of us were entering new territories in our consideration of each other’s work and how it all pieces together to make sense of this thing we call “madness”.

What are you up to now? 
I am a fulltime student in a Masters of Psychology (Clinical) at ACAP. I also work part-time in an organisation that provides a recovery program for women experiencing homelessness and mental health issues.

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