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Abstract
The concept of ‘care’ has been fraught with negative connotations within the disability movement; the concepts of empowerment, choice and control have been developed as alternatives. The peer-support movement in the mental health sector draws from this tradition, and is uncomfortable with the provision of care. Drawing on the feminist ethic of care, we will argue in this paper that ‘care’ – in the sense of caring about, rather than caring for – should be seen as fundamental within peer support. The practice of peer support evidences a kind of ‘care’ that does involve some interdependence, and taking of ‘responsibility’. The challenge is to make this a ‘responsibility towards’, rather than a ‘responsibility for’. If this is successfully achieved, care can indeed become acknowledged as part of ‘standard peer support’, and the basis for the development of autonomy and self-determination.
Notes
1. Velda was using the terms ‘tender loving care’ and ‘motherly love’ in an ironic register, as evidenced by the laughter.
2. A tikanga-based practice is a practice based on Maori protocols. A whakatau is a welcome, while mihi are introductions that combine personal introductions with connections on the basis of whakapapa (geneology) and other connections. A kaumatua is a Maori elder who acts as a guide to the organisation. A kaupapa Maori service is a service based on Maori empowerment and principles.
3. Peer support is increasingly being reviewed. See Doughty and Tse (2011) for a systematic review of published studies of peer support’s effectiveness. See Nelson et al. (Citation2007) for results of a five-year longitudinal study into the effectiveness of peer support in the United States.
4. In this form, it has close connections with the social model of disability.
5. The Independent Living Movement argued for the creation of personal assistants who would be employed by the recipient of care, and would be contractually and philosophically obligated to work in a way that respected his or her decisions and autonomy (Watson et al. Citation2004; Kelly Citation2010). The philosophy of independent living suggested that relationships between caregivers and care receivers should be emptied of emotional content. This did not work out in practice, however. See Kelly (Citation2010).
6. Some have questioned whether mental health consumers should be referred to as a disabled group (Beresford Citation2000). There are mental health consumers who do not consider themselves to be disabled. However, we are convinced by Beresford’s (Citation2000) reasons for bringing these two groups together. Furthermore, as Davidson and his colleagues argue, the concept of ‘Recovery’ has strong parallels in its civil rights influenced form with the social model of disability (Davidson et al. Citation2009: 14–15). Treating mental health consumers and people with disabilities within the same frame of reference adds strength to both groups.
7. Service users are often called ‘peers’ within peer support.
8. These expressions of vulnerability are, of course, problematic in relation to the social model of disability, or the Recovery philosophy, which draw on competence and strengths-based approaches. However, finding a way to acknowledge vulnerability, while sustaining self-determination, is at the root of our approach to ‘care’.
