Institutional ethnography and people with schizophrenia

In this study we have follow the principles of institutional ethnography focussing on the life-world of people with psychosis as it is influenced by professional paradigms, institutional structures and the actions of other actors elsewhere in a larger system.

The data of the investigation stem from three separate studies focussing on the patients’ experience of their mental disorder and their interaction with professionals in mental hospitals and community psychiatry. The studies comprised one and a half month observation of activities and interaction between professionals and clients in each of six different regions in Denmark, including a great number of individual interviews and group interviews with professionals and patients engaged in in-patient and out-patient activities. In addition, questionnaires were distributed to a total of 453 users of out-patient services.

By putting together the different accounts from users of the professional psychiatry as well as the professionals themselves, we seek to identify the institutional barriers for ‘recovery’ or more correct: Living on own terms with a psychosis. Though it is difficult to define what we really mean by ‘own terms’, it seems to be a bit easier to identify the barriers linked to:

1. A categorical diagnostic system that includes a reductionist and stigmatising picture of the patients’ ability and disability.

2. A segregation of the psychiatric support in relatively autonomous systems (child psychiatry and adult psychiatry, affective disorders and psychosis, in-patients and out-patients, treatment and social support, hospital and community psychiatry).

3. Some basic factors linked to the governance of social problems and the self-governance of people with social problems. Factors embedded in the governmentality of modern welfare states that seems to ‘put the blame on the victims’ and transform personal and professional experiences and insight into categories that serves governmental aims.