Juliet Foster

Exploring the Potential of the Theory of Social Representations in Community-Based Health Research—and Vice Versa?

This article seeks to demonstrate the importance of developing a dialogue between social representations theory and community approaches to researching issues of health. We show how we have used the theory within our own research to ground our findings at the level of community. The article is divided into three sections: the recognition of competing systems of knowledge; the role of representations in maintaining stigmatizing practices; and the impact of representations on identities. Each section is illustrated with material drawn from Foster’s research on mental illness and Dorrer’s research on women’s representations of healthy eating. We conclude by arguing that, while social representations theory is a valuable tool for communitybased health research, the theory would benefit from developing a more participatory methodology.

Beyond otherness: controllability and location in mental health service clients' representations of mental health problems.

This paper focuses on a multimethod qualitative study of the social representations of mental health problems held by clients of the mental health services. Clients appear to represent mental health within representational projects, and, in the course of these projects, situate mental health problems at various points within a twodimensional representational structure comprising controllability and location. It will be suggested that the element of Otherness, so integral to public representations of mental ill health, is therefore significantly more complicated in clients’ representations. Similarly, the interaction between these two dimensions suggests that clients move beyond the professional divide between psychosis and neurosis. The implications of these results will be briefly considered.

Representational Projects and Interacting Forms of Knowledge

This paper focuses on the concept of the reified and consensual universes in the theory of social representations, and the relationship between them. Having examined the different ways in which Moscovici discusses this concept, and the different ways in which these discussions have been interpreted, I will suggest that many of the criticisms levelled at this facet of social representations theory appear somewhat misplaced. However, it does seem that some aspects of the concept of the consensual and the reified universes are rather under-developed within the theory as a whole. It will be suggested that the recent addition of the notion of the representational project to the theory of social representations goes some way towards addressing some of these emergent issues, most notably with regards to the relationship between knowledges from different spheres. As an example, the area of representations of health and illness will be considered: drawing on work that takes the perspective of the sociology of scientific knowledge, it will be suggested that the theory of social representations needs to make the possibility of a bi-directional relationship between knowledge from the fields of scientific and common sense understanding more explicit.

Public perceptions of mental health professionals: stigma by association?

Abstract Background: Existing research has identified the phenomenon of associative stigma, but has not robustly illustrated that any stigmatisation of mental health professionals (MHPs) stems from association with clients. Aim: To examine whether public perceptions of MHPs mirror ideas about service users. Method: A mixed-methods approach incorporated statistical analysis of questionnaire results and thematic analysis of focus group transcripts. A convenience sample (N = 260) completed the questionnaire, rating “typical” target professionals (some treating specified mental health conditions) on semantic differential scales. Three focus groups (N = 15) triangulated questionnaire findings. Results: Mirroring mental illness stereotypes, questionnaire participants rated counsellors and psychiatrists as more eccentric and unpredictable than GPs. Professionals specialising in treating substance abuse and schizophrenia were rated as less empathetic, agreeable, predictable and conventional than those treating depression, reflecting differing representations of these conditions. Specialists in depression and schizophrenia were rated as more withdrawn than those treating substance abuse. Focus group participants postulated that mental health problems may cause or result from mental health employment. Conclusion: MHPs seem stigmatised by association with clients. Future research should elucidate the origins of stigma to safeguard professionals’ and clients’ well-being.

Perpetuating stigma?: Differences between advertisements for psychiatric and non-psychiatric medication in two professional journals

Background: Continuing debates regarding advertising and the pharmaceutical industry, and others detailing the continued stigmatization of mental health problems. Aims: To establish whether there are any differences in advertisements for psychiatric and non-psychiatric medication aimed at health professionals. Method: Quantitative (t-tests, Chi-squared) and qualitative analysis of all unique advertisements for medication that appeared in two professional journals (the British Medical Journal and the British Journal of Psychiatry) between October 2005 and September 2006 was undertaken. Close attention was paid to both images and text used in the advertisements. Results: Significant differences were found between advertisements for psychiatric and non-psychiatric medication in both quantitative and qualitative analysis: advertisements for psychiatric medication contain less text and are less likely to include specific information about the actual drug than non-psychiatric medication advertisements; images used in advertisements for psychiatric medication are more negative than those used for non-psychiatric medication, and are less likely to portray people in everyday situations. Conclusion: A distinction between mental health problems and other forms of ill health is clearly being maintained in medication advertisements; this has potentially stigmatizing consequences, both for professional and public perceptions. There are also troubling implications in light of the debates surrounding Direct to Consumer Advertising.

The construction of allegedly abused children's narratives in Scottish criminal courts

ABSTRACT This study investigated lawyers’ use of social narratives surrounding child sexual abuse when questioning 66 5- to 17-year-old alleged victims in Scottish criminal courts using a mixed-methods approach. Thematic analysis found that the use of beliefs and stereotypes varied depending upon the lawyers’ role (defense/prosecution), children’s age, and the alleged victim-defendant relationship. These findings were investigated further using narrative analysis, which showed that, with increasing age and decreasing familiarity with defendants, narratives increasingly focused on the characteristics and actions of the victims rather than the defendants. Older children contributed more to narratives than younger children, but their contributions were only incorporated into the prosecutors’ narratives. Defense lawyers adopted more victim-blaming tactics as the narratives developed. Findings suggest that the criminal justice system, practitioners, and researchers must do more to recognize and guard against the reinforcement of stereotypes that may influence public rhetoric and jury decision-making.

La enfermedad mental en el anciano: representaciones sociales de los estudiantes de medicina em el Reino Unido

Objectivo O estudo propoe investigar as representacoes sociais de estudantes de medicina sobre a doenca mental entre idosos. Metodo a pesquisa qualitativa e exploratoria foi baseada na teoria das representacoes sociais. Os principais metodos utilizados foram dois grupos focais com estudantes pre-clinicos (grupo 1, N=4; grupo 2, N=4) e dez entrevistas individuais com estudantes em pratica clinica. A analise tematica explorou os significados e diferencas entre os grupos. Resultados Tres principais temas refletem as representacoes dos participantes sobre a doenca mental na velhice: doenca mental na velhice, polarizacao do cuidado, desafios ao cuidado. A atencao primaria a saude constitui uma estrategia importante para ultrapassar barreiras ao cuidado em saude mental na comunidade. Contudo, crencas depreciativas, estigma e organizacao de servicos se apresentam como os principais desafios. Conclusao Esse estudo aponta para a necessidade de profissionais de saude responderem aos desafios culturais e organizacionais ao cuidado em saude mental do idoso.

Mental ill health in the elderly: medical students’ social representations in the United Kingdom

Objectivo O estudo propoe investigar as representacoes sociais de estudantes de medicina sobre a doenca mental entre idosos. Metodo a pesquisa qualitativa e exploratoria foi baseada na teoria das representacoes sociais. Os principais metodos utilizados foram dois grupos focais com estudantes pre-clinicos (grupo 1, N=4; grupo 2, N=4) e dez entrevistas individuais com estudantes em pratica clinica. A analise tematica explorou os significados e diferencas entre os grupos. Resultados Tres principais temas refletem as representacoes dos participantes sobre a doenca mental na velhice: doenca mental na velhice, polarizacao do cuidado, desafios ao cuidado. A atencao primaria a saude constitui uma estrategia importante para ultrapassar barreiras ao cuidado em saude mental na comunidade. Contudo, crencas depreciativas, estigma e organizacao de servicos se apresentam como os principais desafios. Conclusao Esse estudo aponta para a necessidade de profissionais de saude responderem aos desafios culturais e organizacionais ao cuidado em saude mental do idoso.

A doença mental no idoso: representações sociais de estudantes de medicina no Reino Unido

Objectivo O estudo propoe investigar as representacoes sociais de estudantes de medicina sobre a doenca mental entre idosos. Metodo a pesquisa qualitativa e exploratoria foi baseada na teoria das representacoes sociais. Os principais metodos utilizados foram dois grupos focais com estudantes pre-clinicos (grupo 1, N=4; grupo 2, N=4) e dez entrevistas individuais com estudantes em pratica clinica. A analise tematica explorou os significados e diferencas entre os grupos. Resultados Tres principais temas refletem as representacoes dos participantes sobre a doenca mental na velhice: doenca mental na velhice, polarizacao do cuidado, desafios ao cuidado. A atencao primaria a saude constitui uma estrategia importante para ultrapassar barreiras ao cuidado em saude mental na comunidade. Contudo, crencas depreciativas, estigma e organizacao de servicos se apresentam como os principais desafios. Conclusao Esse estudo aponta para a necessidade de profissionais de saude responderem aos desafios culturais e organizacionais ao cuidado em saude mental do idoso.

Afterword: Relocating Madness

This is a book about madness, space and performance. In it we have paused over these three concepts and their interrelations in order to try to better understand the cultural politics and meanings of madness. The diverse, even clashing, voices in the collection evidence how far this remains fiercely contested terrain. All our authors would claim, in distinct ways through their academic, professional, clinical or crea tive practices, to be engaged with questions of madness, whether they employ this term or prefer another such as psychosis, mental illness, psychological distress, alterity and so on. As this volume makes lumi nous, their conceptualisation of such experiences differs significantly. This raises the question of precisely what we speak of when we talk of ‘madness’ today. While the book makes no claim to offer the last word in this conversation, it hopes to have sustained and developed timely questions about power, politics, minds and voices. Moreover, it hopes to have prompted further reflections about how far madness might be understood as a state of being, a set of actions or behaviours, an ordinary experience, a myth, a protest, a disease, a gift. Although each author could offer their own conclusion to the provocative question, what is madness? — it remains for the reader to consider her own footing within this politicised landscape. We hope the eclecticism of the voices herein provides useful food for thought.