Sessions, Speakers, Co-Authors, and Abstracts
Rehabilitating ‘The System’: Global Stories of Regulation, Recovery and Empowerment
Michael Wearing. Social Sciences and International Studies, University of New South Wales, Sydney, NSW, Australia
Professional Governance and Psychiatric Knowledge in Australian Mental Health Practice – Examining Discourses of Recovery and Consumerism in the Health Care Professions
This paper will explore the constructions of mental health workforce competences and standards in Australia with reference to other countries such as the USA and New Zealand. A range of professional and governmental discourse on standards is explored including scientific and psychiatric accounts, and consumer perspectives derived from lay and experiential narrative and participation. The use of psychiatric knowledge in mental health services and by professionals is defined in part by the ability to classify and govern others with a highly specialised and ‘scientistic’ knowledge. This governance of ‘illness’ is outlined in a brief history of psychiatry and related bio-behavioural paradigms. This paper deals with specific constructions of ‘recovery’ and consumerism in the health care professions including nursing, psychology and social work. This remains an under-examined area of health and allied health work. Professionalisation is then discussed in relation to issues of medical dominance and psychiatrization in the delivery of services, and how such coded knowledge is translated and disseminated into training programs, formal learning and professional practice.
In this framework, professional governance of the mentally ill is conceived mostly as a reactive set of discourses that in neo-liberal and residual welfare states seeks to regulate against risk and danger, and perpetuate fears of the ‘constructed other’. To challenge new modes of regulation of illness a careful path for mental health professionals is suggested using a reflexive knowledge and ethics with an emphasis on consumer participation where identity and difference are respected. Drawing on recent work (Wearing 2005, Hughes and Wearing 2007), the author argues that upwards, sideways and internal shaping of human and health service organizations by participatory and more democratic use of knowledge/power will challenge dominant and objectifying knowledge about mental health clients in these services. Understanding how multiple forms of professional knowledge govern practice can reframe thinking on both the effects of psychiatric