Decision-making in mental healthcare: a phenomenological investigation of service user perspectives

Wharne, Simon; Langdridge, Darren and Motzkau, Johanna (2012). Decision-making in mental healthcare: a phenomenological investigation of service user perspectives. The Humanistic Psychologist, 40(2) pp. 153–165.

DOI: https://doi.org/10.1080/08873267.2012.669357

Abstract

As Victorian asylums closed down in the UK, community mental health services were set up to support patients in exercising choice and freedom; in finding a place in society. The success of these services has been questioned so further policies have been introduced in an effort to protect rights and improve social inclusion. However, ‘capacity to make decisions’ has been interpreted as no more than a process of rational mental calculation. This article reports on a phenomenological study, which explores the decision-making experiences of three men who have endured psychosis. It is not only associated with choice and freedom but also with responsibility, blame and social exclusion. These men appear to have faced common existential dilemmas, but have sought to express emotional will in conflict with other people and have perhaps been placed under more social pressure and become more isolated as individuals, while enduring experiences which are difficult to make meaningful for others. It seems that, paradoxically, efforts have been made to empower these men by controlling them and medication has been imposed on them so as to regulate thoughts and moods, in attempts to serve their best interests.

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