Using autoethnography to reclaim the ‘place of healing’ in mental health care

• Published in: Social science & medicine (1982) 2013-08, Vol.91, p.105-109
• Main Authors: Liggins, J., Kearns, R.A., Adams, P.J.
• Format: Article
• Language: English
• Subjects: Autoethnography; Biological and medical sciences; Community; Geography; Healing; Hospitals; Hospitals, Psychiatric - organization & administration; Humans; Illness; Medical sciences; Mental disorders; Mental Disorders - therapy; Mental Health; Mental health care; Mental Health Services; Mental illness; Miscellaneous; Narration; New Zealand; Place; Policy Making; Psychiatric hospital; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of Health Care; Service-user; Silence; Therapeutic landscape
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2012.06.013

Geographies of mental health in the era of deinstitutionalisation have examined a range of places, policy processes and people's experiences associated with community care. However, such assessments have tended, given their community focus, to necessarily be silent on the character of inpatient spaces of care. There is silence too on the potential of such spaces to assist in the healing journey. While there have been a few investigations of hospital design, there has been little consideration of users' experiences of hospital spaces as critical sites and spaces of transition on the illness journey. In this paper, we critically reflect on a project that seeks, two decades after the closure of the last major institution in New Zealand, to investigate the acute care environment with an emphasis on its capacity for healing. The vehicle facilitating this investigation is a novel approach to understanding the inpatient journey: autoethnography. This methodology allows the first author (JL) to critically reflect on her multiple roles as compassionate observer, service-user and mental health professional, and developing transdisciplinary insights that, in conversation with the other authors' geographical (RK) and psychological (PA) vantage points, assist in the reconsideration of the place of the inpatient unit as a place of healing. The paper reveals how voice, experience and theory become mutually entwined concerns in an investigation which potentially stretches the therapeutic landscape idea through critical attention to the redemptive qualities of place by means of attentiveness to both the world within and the world without. ► Autoethnography is proposed for an investigation of the healing capacity of psychiatric acute care environments. ► Autoethnography places the service-user within the research process as key collaborator if not sole investigator. ► The authors critically draw on their multiple roles including service-user, health professional, geographer, and psychologist. ► Voice, experience and theory become mutually entwined concerns potentially stretching the therapeutic landscape concept.