The contemporary dynamics of caring – A qualitative study of the relationship between mental health professionals and carers of people with long term mental health conditions

Walsh, Jeremy (2015) The contemporary dynamics of caring – A qualitative study of the relationship between mental health professionals and carers of people with long term mental health conditions. Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust. Full text available

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At the heart of this study is the experience of caring for someone with a long term mental health condition and the relationship between mental health professionals and carers, who are largely family, partners or friends. The study has been conducted at a time when there is increasing awareness of carers but at the same time limited understanding of the day-to-day lives of people caring for someone with a mental health condition. Using a psychoanalytically informed psychosocial approach seven carers and eight mental health professionals were interviewed using a free association narrative interviewing approach, which provided a framework for participants to share their experiences. In the next phase a combined focus group of 16 participants was held, comprising nine carers and seven mental health professionals and vignettes were utilised to facilitate discussion. Data from both methods was analysed using a reflexive and psychoanalytical approach which encouraged the emotional response of the researcher to be taken into account. Alongside, a thematic analysis was undertaken to enable cross-referencing. The study found that the disturbing nature of mental health conditions directly affects carers and mental health professionals, and within this environment carers place high value on support that is built on a meaningful relationship with a mental health professional. However this is not always available as professionals seek to defend themselves from the distress that is bound up in the caring experience, and therefore they idealise carers and maintain professional distance, with the result that carers’ anxiety is not dealt with effectively. Three implications are drawn from the research: firstly, that relational based support is developed based on the principles of ‘being alongside’ which includes: discerning those issues that need immediate response, and those that need time for a period of reflection, honesty about the nature of mental illness and what is realistic, agreeing respective expectations at the beginning of the work, and valuing seemingly mundane and everyday achievements that are often overlooked. Secondly, that there is no such thing as a service user, only a service user in relation to their carer, and the two are a unit that must be worked with together by the professional. Finally, that the framework of care in the community should adopt a different model in which the structures of an institution are utilised. Therefore each service user, carer and mental health professional form a mini community institution in which they all become members of the institution, and have a role in developing it.

Item Type: Thesis (Professional Doctorate)
Additional Information: Thesis submitted in partial fulfilment of the Professional Doctorate in Social Work awarded by the University of East London in collaboration with the Tavistock and Portman NHS Foundation Trust
Uncontrolled Keywords: Professional Doctorate in Social Work, D60
Subjects: Disabilities & Disorders (mental & physical) > Mental Health - Social Welfare
Social Welfare > Social Welfare Personnel
Social Welfare > Social Work
Department/People: Children, Young Adult and Family Services

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