Mental health rehabilitees' agency construction and promotion in community-based transitional work programme

Int J Qual Stud Health Well-being. 2023 Dec;18(1):2202972. doi: 10.1080/17482631.2023.2202972.

Abstract

Purpose: The integration of mental health rehabilitees into the labour market is an important policy objective everywhere in the world. The international Clubhouse organization is a third-sector actor that offers community-based psychosocial rehabilitation and supports and promotes rehabilitees' state of acting and exerting power over their lives, including their (re)employment. In this article, we adopt the perspective of discursive psychology and ask how mental health rehabilitees' agency is constructed and ideally also promoted in the Clubhouse-based Transitional Employment (TE) programme.

Methods: The data consisted of 26 video-recorded TE meetings in which staff and rehabilitees of one Finnish Clubhouse discussed ways to further their contacts with potential employers. The analysis was informed by discursive psychology, which has been heavily influenced by conversation analysis.

Results: The analysis demonstrated how rehabilitees adopt agentic positions in respect to TE-related future activities, and how Clubhouse staff promote and encourage but also discourage and invalidate these agentic positionings. The analysis demonstrated the multifaceted nature of agency and agency promotion in the TE programme.

Conclusions: Although ideally, Clubhouse activities are based on equal opportunities, in everyday interaction practices, the staff exercise significant power over the question whose agency is promoted and validated in the TE programme.

Keywords: Agency; Clubhouse; conversation analysis; discursive psychology; mental illness; transitional work.

MeSH terms

  • Employment
  • Finland
  • Humans
  • Mental Disorders* / psychology
  • Mental Health
  • Psychiatric Rehabilitation* / methods

Grants and funding

The work was supported by the Academy of Finland [307630]; University of Helsinki [HY/66/05.01.07/2017].