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dc.contributor.advisorParkes, Tessa-
dc.contributor.advisorCairney, Paul-
dc.contributor.advisorRing, Nicola-
dc.contributor.authorBooth, Hazel-
dc.description.abstractSelf-management is widely promoted in policy and practice as a way to manage mental illness but, despite many years of effort, a wide variety of those who promote/use it perceive that it is not living up to expectations. I wanted to explore how self-management for mental illness was understood, more specifically whether the ‘person-centred’ model that is often promoted alongside ‘self-management’ was evident or if the ‘medical model’ prevailed. This may shed light on the way in which self-care is viewed and enacted by both policymakers and practitioners. I devised a three-stage qualitative study asking 1) how policymakers understand self-management for mental illness, 2) how people and healthcare practitioners understand it in relation to bipolar affective disorder, and 3) how a small group of people understand it more generally as it relates to mental illness. After the three stages I concluded that, despite some differences, in policy and healthcare practice self-management is understood medically in a particular way, in terms of what is done, by whom, how, and why. Central to that understanding is a paradoxical epistemology which limits how much a person living with a diagnosis can know about themselves, and privileges how much other people know about them. The epistemic paradox is resolved in practice by what I have termed “epistemic forfeit”, whereby individuals living with a diagnosis share the task of monitoring their health with others on an ongoing basis. This means that self-management of mental illness is a task which must always be shared by healthcare professionals, and sharing is thus a condition of receiving care. The capacity to share this task is however restricted because services are under increasing financial, time, and caseload pressure. I argue that this may contribute to the sense that self-management is not working in practice. The thesis ends with a set of recommendations regarding how the healthcare system might adapt to provide the oversight medically understood self-management requires.en_GB
dc.publisherUniversity of Stirlingen_GB
dc.subjectmental healthen_GB
dc.subjectmental illnessen_GB
dc.subjectmodels of mental healthen_GB
dc.subjectmedical model of mental healthen_GB
dc.subjectcritical mental healthen_GB
dc.subjectepistemic forfeiten_GB
dc.subjectepistemic paradoxen_GB
dc.subjectsocial model of mental healthen_GB
dc.titleA qualitative exploration of the nature of the medical model in self-management of mental illness: navigating paradoxes and forfeitsen_GB
dc.typeThesis or Dissertationen_GB
dc.type.qualificationnameDoctor of Philosophyen_GB
dc.rights.embargoreasonI would like to embargo the electronic thesis for a year so that I may publish from it. My PhD was funded by an ESRC studentship, but I believe embargo is acceptable for a year. If required I will seek an extension to the embargo at a later date to a maximum of 2 yearsen_GB
dc.contributor.funderThis work was funded by an ESRC studentship awarden_GB
Appears in Collections:Faculty of Social Sciences eTheses

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