Seeking fluid possibility and solid ground: space and movement in mental health service users' experiences of 'crisis'

Soc Sci Med. 2015 Mar:128:115-25. doi: 10.1016/j.socscimed.2015.01.017. Epub 2015 Jan 14.

Abstract

Since the closure of the UK asylums, 'the community' has become short hand for describing a variety of disparate and complex spaces, in which service users manage their experiences of distress. An examination of such spaces here forms the basis of an analysis of the way in which service users move through and within space, to establish agency and dis/order while distressed. Seventeen participants, with various experiences of mental distress took part in a qualitative study, and a further textual analysis was conducted on eight published autobiographies. In the context of the interviews, participants presented drawings of the spaces they occupy during times of crisis, wellbeing and recovery. All texts were analysed using a thematic approach, informed by theories of embodiment and relational space. In this paper, the focus is directed towards two key patterns of movement, in order to explore ways in which participants experiencing various forms of mental health crisis used space in order to maintain and manage feelings of agency. Firstly, incidents where participants described moving towards fluid, outside spaces are explored, with agency being established through seeking, and utilising, greater possibilities for action and engaging others. In addition, the opposite pattern of movement is also explored, using incidents where participants described moving indoors, using the private space of the home to establish order and restore feelings of agency and strength, in contrast to overwhelming experiences in public space. Connections between these patterns of movement and particular forms of distress are discussed. It is argued that community and private spaces are integral to the ways in which selfhood, agency and action is experienced in mental distress, which in turn has implications for policy, treatment and community action.

Keywords: Anxiety; Community care; Crisis; Materiality; Mental health; Movement; Psychosis; Relationality; Space; United Kingdom.

MeSH terms

  • Community Mental Health Services / statistics & numerical data*
  • Environment*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Psychotic Disorders / psychology*
  • United Kingdom