%0 Journal Article
%T The Knowledge Concealed in Users¡¯ Narratives, Valuing Clients¡¯ Experiences as Coherent Knowledge in Their Own Right
%A Ragnfrid Kogstad
%A Tor-Johan Ekeland
%A Jan Kaare Hummelvoll
%J Advances in Psychiatry
%D 2014
%R 10.1155/2014/786138
%X Objective. As the history of psychiatry has been written, users have told their stories and often presented pictures incompatible with the professional or official versions. We ask if such a gap still exists and what the ethical as well as epistemological implications may be. Study Design. The design is based on a hermeneutic-phenomenological approach, with a qualitative content analysis of the narratives. Data Sources. The paper draws on user narratives written after the year 2000, describing positive and negative experiences with the mental health services. Extraction Methods. Among 972 users answering a questionnaire, 492 also answered the open questions and wrote one or two stories. We received 715 stories. 610 contained enough information to be included in this narrative analysis. Principal Findings. The stories are coherent, containing traditional narrative plots, but reports about miscommunication, rejection, lack of responsiveness, and humiliation are numerous. Conclusions. The picture drawn from this material has ethical as well as epistemological implications and motivates reflections upon theoretical and practical consequences when users¡¯ experiences do not influence professional knowledge to a larger degree. 1. Introduction The stories from a subjective or patient perspective have followed the official story of psychiatry like a side stream [1¨C3]. Listening to the nonexperts, ¡°ordinary people¡± or ¡°victims of history¡± [4], has a long tradition in social science. Women, workers, the colonialized, religious minorities, prisoners, the ill, and also the ¡°mad¡± have in turn had their voices heard. But listening to valuing and appreciating the stories of the mentally disabled has been a more complicated case and has needed more time for reasons we will return to. As expressed by Molinari [5] there has been a kind of an unequal relationship between the client who writes to express his/her truth and the professional reader who reads the story to confirm his/her diagnosis. Even if users¡¯ perspective gradually has been set on the agenda and user involvement is established as a method for improving the health services [6¨C8], user involvement in the field of mental health care still does not avoid the asymmetrical relations between users and professionals, not the least because of the possibility of diagnosing users¡¯ opinions [9] rather than receiving their feedback and narratives as helpful corrections necessary in the process of improving the delivery of health services. As a consequence user involvement may be regarded only as an empowerment strategy
%U http://www.hindawi.com/journals/apsy/2014/786138/