Relative views of madness : families' experiences of living with mental illness
This study examines the experiences of relatives of people suffering from long-term mental illness. The impetus and context for this study has been provided by the well publicised Regional Health Authority sponsored closure programmes of Friern and Claybury Psychiatric Hospitals. These planned closures have emerged from several decades of a fairly consistent, nation wide, shift of services from the old hospital sites to the community. The study has taken place amid a certain amount of confusion about the future direction of Community Care policy. In an attempt to grapple with this, the particular focus for the thesis is the experiences of relatives of people who in past decades might have found their homes within the Asylums, had they not been closing. It is argued that study around this group provides valuable insight into current difficulties. On a policy level it is argued that it has been, albeit largely unacknowledged, anxiety about 'the family' that has been significantly orchestrating the broad sweep of mental health policy changes, certainly since the middle of the last century. A review and critique of previous models used to study 'families and mental illness' is provided. Their failure to capture vital aspects of the relatives' experiences is highlighted. The roots of this failure are charted within the dominant paradigms of social science and their social and political contexts. Using material from in depth interviews the devices employed by relatives to construct and attach meaning to their experiences are explored. It is argued that relatives are involved in a negotiation of meaning within the discourses that surround them. The relatives' experiences are examined in terms of the complex grief process, the experience of shame and the encounter with stigma which all take place within the framework of meaning provided by 'the family'. Here, as these apparently intimate affects are explored, and their social significance highlighted it becomes clear that the traditional paradigms of social science that, for example make great distinction between psychological and sociological levels of understanding, are insufficient.