Michele Crossley

What is the 'voice' of the mental health 'user'? This paper seeks to address this question through the presentation of a detailed comparative analysis of two anthologies written by people living with mental 'illness' in the 1950s and 1990s. Using a narrative-style qualitative analysis, the structure and content of the two anthologies is explored. The analysis illustrates the way in which the 'voice' of the mental patient in the 1950s was very different to that of today. The paper then aims to provide a theoretical explanation that accounts for this transformation of voice. Appropriating theoretical concepts from phenomenology and sociology, in particular, Bourdieu's concept of 'habitus', the paper explores the way in which the 'personal' voice of the mental patient is formulated in dialogical relation to wider public and collective movements. These, in turn, connect to broader transformations in the social, economic and health &#39...

Interventions designed to change behavior delivered to groups rather than individuals are popular in health promotion and self-management. The 7-week positive self-management program (PSMP) for people with HIV status is adapted from a psychoeducational program designed to increase people's capacity to manage their conditions by enhancing self-efficacy. A case study using mixed qualitative methodology included pre- and postcourse interviews with 14 participants plus participant observation and focused on changes in attitude toward self-management responsibility. The authors identified a precourse typology of motivations and expectations: Hopeless, Recovery phase, or Questioning phase. Participants adopted roles (information seekers or information givers) related to these types. Some expectations and problems were not dealt with because the PSMP's philosophical grounding prioritized improvement of self-efficacy, precluding engagement with material and social needs. Collective user-defined need and support from host organizations might be more important in improving self-management than the structured content of chronic disease self-management programs.