Risk, trust and the myth of mental health services

Abstract

Background: Strictly “mental health” should, as its name suggests, be about health, yet there is now a global discourse about “mental health” which actually alludes mainly to the clinical, organizational and legal aspects of managing mental disorder. Indeed, “mental health” law deals with the conditions under which people diagnosed with mental disorder can be lawfully compelled to accept treatment. This paradoxical use of language requires further examination.

Aims: The paper aims to problematize the taken for granted notion of “mental health services”.

Method: It draws upon general sociological work on “risk” and “trust”. The trustworthiness of ordinary language accounts and professional codifications are considered before examining the sociological implications of the controversy about the abuse of psychiatry. The risks to and from patients in routine mental health work, and the betrayal of trust as both a normal part of care and its corruption in mental health work are outlined.

Conclusions: The paper concludes that “mental health services” are a myth in as much as they are mostly concerned with mental disorder and control (at least to the bulk of identified patients which form the focus of their activity).

Keywords:

• Risk
• trust
• mental health