The patient's world: discourse analysis and ethnography

Abstract

In this article, I would like to consider the contribution of discourse analysis to ethnography in mental health settings. I am particularly interested in how a discourse analysis of in situ interviews can offer an important perspective to ethnographic exploration of mental health services. This theoretical consideration is complemented with two sets of data. On the one hand, it is based on an ethnographic insight into the practices in an elite Polish psychiatric hospital; on the other hand, it is based on service users' account of the initial psychiatric interviews carried out immediately after their admission onto a ward in the hospital. All the interviewees had a preliminary diagnosis of the depressive disorder (ICD10 F32–33). I am going to demonstrate a hiatus between the ethnographic account of the practices observed through an ethnographic study and their constructions in the service users' narratives. In this process, I am going to argue that discourse analysis is a crucial complement to an ethnographic study.

Keywords:

• discourse
• critical discourse analysis
• ethnography
• service users’
• accounts
• psychiatric interview
• mental health

Notes

The translations of the data are mine. I have tried to render both not only the content of what has been said but also, as much as possible, the form or the ‘flavour’ of what has been said. This occasionally results in ‘bad’ or disjointed English. While I have tried to keep the transcription system to the bare minimum, I have also decided not to include any transcription indicators in the translations. The grammatical structures of Polish and English differ enough to make the task in many cases virtually impossible. The interviews were all carried out by a female interviewer, a psychologist and come from a larger project.

The expression consists of the polite form (feminine pani or masculine pan) and the professional title (doktor). The closest translation would be ‘Madam/Mr Doctor’ which in English sounds quite bizarre, yet in German Frau/Herr Doktor' sounds perfectly acceptable.

A comment on two words is necessary. Polish ‘ubiegac sie’ is closest to the English ‘to be an applicant’. It refers to the actions done by an applicant in their attempts to get what they apply for. But is also clearly connotes the power of those with the gift of what has been applied for to refuse. Polish ‘rzetelny’ in turn is a word predominantly from a broadly understood business sphere of life. ‘Rzetelny’ assumes that one can be relied upon to do their duties (it could also be household chores) and the product of such activities will be well-done.