Tuesday, 7 July 2009

Capacity, wellbeing and mental health

Today’s Institute for Philosophy, Diversity and Mental Health colloquium took the theme of individual and community capacity and wellbeing. The key feature of these annual colloquia is the interplay of philosophy, psychiatry and a mental health service user voices. (The European service user group ENUSP holds its business meeting at Uclan immediately before.) But this presents a real challenge because, even within a meeting with obviously good intentions, there is going to be no easy reconciliation between active service users and working psychiatrists who have taken, so to speak, the King’s shilling.

Of course there are psychiatrists who, eg., eschew all diagnosis (when that is possible in view of the way mental healthcare is funded) and avoid drug treatments. But that is not the only approach taken by psychiatrists within the broader intellectual movement.

One general concern raised by Jan Verhaegh of ENUSP was how could members of service user organisations appear as subjects rather than objects of mental healthcare? In particular, he asked why, despite the broad concerns and range of sympathies manifested in the OUP IPPP series, were service user organisations not directly mentioned within it? Whatever the contingent reasons for this, the two concerns together suggest a tension in how to address the latter since simply being written about by others – me, for example – might itself form a kind of objectification.

During the course of the day I began to have a sense of how the two ‘dimensions’ (individual vs. community; and wellbeing and capacity: OK so not really a dimension) interacted asymmetrically. Whilst the work discussed at the community level readily suggested positive and interrelated notions of wellbeing and capacity (social or community capacity helping to underpin social or community wellbeing), at the individual level capacity seems to be something to be lost (measured, negatively, under the Mental Capacity Act) and wellbeing more naturally merely the absence of illness. Of course, it needn’t be seen like that but it will take some work to turn those habits of thought around.

See here for thoughts on capacity and unwise decisions.