IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v68y2009i7p1213-1220.html
   My bibliography  Save this article

A discourse analysis on how service providers in non-medical primary health and social care services understand their roles in mental health care

Author

Listed:
  • Mitchell, Penelope Fay

Abstract

Enhancing collaboration between specialist mental health services, primary health care and social care services has been a key priority in mental health policy reform in many countries for about 20 years and remains so. Yet progress in terms of widespread implementation of demonstrably effective models of collaborative care has been slow. The views that different providers hold regarding the parameters of their roles, and the values that guide their approach to service delivery, are likely to exert profound effects on engagement with collaborative initiatives. Little research has explored these issues. In this study, discourse analysis from a structurational perspective was used to explore the views of providers in a diverse purposive sample of non-medical primary health and social care services in the state of Victoria, Australia regarding their mental health care roles. Four interconnected discourses were revealed as supporting role positions constructed in opposition to the putative role positions of specialist mental health services: an informal as opposed to a formal approach; a normalising as opposed to a pathologising approach; holistic social and emotional health and wellbeing, and an individualised or client-focused model of care as opposed to an illness-focused model. These oppositional role constructions may contribute to reluctance among providers in these sectors to engage with some agendas being promoted by specialist mental health services, through either reduced self-efficacy or active resistance to innovations that conflict with strongly held values. Greater awareness of, and critical reflection upon, contrasting role constructions, and the implications of these for practice may facilitate the design of more appropriate collaborative models and stronger commitment to their implementation.

Suggested Citation

  • Mitchell, Penelope Fay, 2009. "A discourse analysis on how service providers in non-medical primary health and social care services understand their roles in mental health care," Social Science & Medicine, Elsevier, vol. 68(7), pages 1213-1220, April.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:7:p:1213-1220
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(09)00002-1
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Loizos Heracleous, 2006. "A Tale of Three Discourses: The Dominant, the Strategic and the Marginalized," Journal of Management Studies, Wiley Blackwell, vol. 43(5), pages 1059-1087, July.
    2. Breheny, Mary & Stephens, Christine, 2007. "Irreconcilable differences: Health professionals' constructions of adolescence and motherhood," Social Science & Medicine, Elsevier, vol. 64(1), pages 112-124, January.
    3. Dew, Kevin & Dowell, Anthony & McLeod, Deborah & Collings, Sunny & Bushnell, John, 2005. ""This glorious twilight zone of uncertainty": Mental health consultations in general practice in New Zealand," Social Science & Medicine, Elsevier, vol. 61(6), pages 1189-1200, September.
    4. Petersen, Inge, 2000. "Comprehensive integrated primary mental health care for South Africa. Pipedream or possibility?," Social Science & Medicine, Elsevier, vol. 51(3), pages 321-334, August.
    5. McKinlay, Eileen & Plumridge, Libby & McBain, Lynn & McLeod, Deborah & Pullon, Susan & Brown, Selina, 2005. ""What sort of health promotion are you talking about?": a discourse analysis of the talk of general practitioners," Social Science & Medicine, Elsevier, vol. 60(5), pages 1099-1106, March.
    6. Bob Hudson & Brian Hardy & Melanie Henwood & Gerald Wistow, 1997. "Strategic Alliances: Working Across Professional Boundaries: Primary Health Care and Social Care," Public Money & Management, Taylor & Francis Journals, vol. 17(4), pages 25-30, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Hilligoss, Brian, 2014. "Selling patients and other metaphors: A discourse analysis of the interpretive frames that shape emergency department admission handoffs," Social Science & Medicine, Elsevier, vol. 102(C), pages 119-128.
    2. Lynch, Johanna M. & Askew, Deborah A. & Mitchell, Geoffrey K. & Hegarty, Kelsey L., 2012. "Beyond symptoms: Defining primary care mental health clinical assessment priorities, content and process," Social Science & Medicine, Elsevier, vol. 74(2), pages 143-149.
    3. Mitchell, Penelope F., 2011. "Evidence-based practice in real-world services for young people with complex needs: New opportunities suggested by recent implementation science," Children and Youth Services Review, Elsevier, vol. 33(2), pages 207-216, February.
    4. Mathieu Roy & Pierre Dagenais & Linda Pinsonneault & Véronique Déry, 2019. "Better care through an optimized mental health services continuum (Eastern Townships, Québec, Canada): A systematic and multisource literature review," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 111-130, January.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kate Robinson & Bernard McKenna & David Rooney, 2022. "The Relationship of Risk to Rules, Values, Virtues, and Moral Complexity: What We can Learn from the Moral Struggles of Military Leaders," Journal of Business Ethics, Springer, vol. 179(3), pages 749-766, September.
    2. Winston Kwon & Ian Clarke & Ruth Wodak, 2014. "Micro-Level Discursive Strategies for Constructing Shared Views around Strategic Issues in Team Meetings," Journal of Management Studies, Wiley Blackwell, vol. 51(2), pages 265-290, March.
    3. Lewin, Simon & Green, Judith, 2009. "Ritual and the organisation of care in primary care clinics in Cape Town, South Africa," Social Science & Medicine, Elsevier, vol. 68(8), pages 1464-1471, April.
    4. Eero Vaara & Andrea Whittle, 2022. "Common Sense, New Sense or Non‐Sense? A Critical Discursive Perspective on Power in Collective Sensemaking," Journal of Management Studies, Wiley Blackwell, vol. 59(3), pages 755-781, May.
    5. Anakwenze, Obianujunwa, 2022. "The cultural sensitivity continuum of mental health interventions in Sub-Saharan Africa: A systematic review," Social Science & Medicine, Elsevier, vol. 306(C).
    6. Stevens, Lindsay M., 2015. "Planning parenthood: Health care providers' perspectives on pregnancy intention, readiness, and family planning," Social Science & Medicine, Elsevier, vol. 139(C), pages 44-52.
    7. Maria Giulia Olivari & Gaia Cuccì & Emanuela Confalonieri, 2016. "“Beyond Personal Beliefsâ€," SAGE Open, , vol. 6(4), pages 21582440166, October.
    8. Shirley Leitch & Ian Palmer, 2010. "Analysing Texts in Context: Current Practices and New Protocols for Critical Discourse Analysis in Organization Studies," Journal of Management Studies, Wiley Blackwell, vol. 47(6), pages 1194-1212, September.
    9. Amrita Joshi, 2018. "Logo dynamics for investment branding: a visual–semiotic analysis of the reframing devices in the Make in India logo," Place Branding and Public Diplomacy, Palgrave Macmillan, vol. 14(3), pages 163-174, August.
    10. Lilie Chouliaraki & Norman Fairclough, 2010. "Critical Discourse Analysis in Organizational Studies: Towards an Integrationist Methodology," Journal of Management Studies, Wiley Blackwell, vol. 47(6), pages 1213-1218, September.
    11. Kirsti Iivonen & Johanna Moisander, 2015. "Rhetorical Construction of Narcissistic CSR Orientation," Journal of Business Ethics, Springer, vol. 131(3), pages 649-664, October.
    12. André Spicer & Graham Sewell, 2010. "From National Service to Global Player: Transforming the Organizational Logic of a Public Broadcaster," Journal of Management Studies, Wiley Blackwell, vol. 47(6), pages 913-943, September.
    13. Virpi Sorsa & Eero Vaara, 2020. "How Can Pluralistic Organizations Proceed with Strategic Change? A Processual Account of Rhetorical Contestation, Convergence, and Partial Agreement in a Nordic City Organization," Organization Science, INFORMS, vol. 31(4), pages 839-864, July.
    14. John Sillince & Paula Jarzabkowski & Duncan Shaw, 2012. "Shaping Strategic Action Through the Rhetorical Construction and Exploitation of Ambiguity," Organization Science, INFORMS, vol. 23(3), pages 630-650, June.
    15. Julia Balogun & Claus Jacobs & Paula Jarzabkowski & Saku Mantere & Eero Vaara, 2014. "Placing Strategy Discourse in Context: Sociomateriality, Sensemaking, and Power," Journal of Management Studies, Wiley Blackwell, vol. 51(2), pages 175-201, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:68:y:2009:i:7:p:1213-1220. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.