About ReValuing Care

‘Who is Helping Who?’ – Co-Production and Professional Boundaries within Social Care services.

By Nick Andrews

I have been working in education and social care for thirty years, and have seen various new initiatives and buzz words come and go, whilst the fundamental principles of humanity remain the same. ‘Co-production’ in its truest senses is grounded in these principles. However, as with the concepts of ‘personalisation’ and ‘reablement’, there is a real danger that the term  ‘co-production’ is misused for hegemonic purposes to cover up what is essentially a cost cutting exercise. Under this scenario, individuals and their communities are expected to take on more responsibility for their own well-being whilst the machine of impersonal and ‘professionalised’ public services carries on as it always has done, albeit it with a few less staff employed. In my opinion, this would be a travesty and missed opportunity to restore warm humanity as the driving force for public services, not compliance with increasingly centralised and de-personalised processes and systems.

One of my favourite quotes by the theologian Martin Buber is ‘all real living is meeting’. Please note that Buber’s understanding of the term ‘meeting’ is much richer than the idea of putting a group of people together in a room or placing nurses and social workers in the same office, which is commonly assumed to result in integrated practice. I am sure many people will share my experience of being in meetings where no one actually met, where each person had their own agenda and the purpose of the meeting was to get this across – to win the argument.  For Buber, ‘meeting’ is about genuinely connecting with other people and being changed in some way by the process. In order to explain this process, he talks about two ways of relating to people and the world, which he calls ‘I-It’ and ‘I-Thou’.

In ‘I-it’ relationships, the person is detached and unaffected. In ‘I-Thou’ relationships, the person is attached and vulnerable. Tom Kitwood, in his seminal book ‘Dementia Reconsidered – The Person Comes First’ talks about his experience of seeing how people living with dementia were dehumanised through receiving emotionally detached task based care:

‘A man or woman could be given the most accurate diagnosis, subjected to the most thorough assessment, provided with a highly detailed care plan and given a place in the most pleasant of surroundings – without any meeting of the I-Thou kind ever having taken place’ (Kitwood, 1997)

By contrast, I believe that genuine co-production facilitates and nurtures the development of ‘I-Thou’ relationships between all parties, which in so doing begins to challenge the prevailing understanding of professionalism and professional boundaries.  In relation to this, I am currently co-ordinating a NISCHR and Joseph Rowntree Foundation (JRF) funded project in Wales, which is focused on the use of evidence from their ‘A Better Life – for older people with high support needs’ programme, along with other forms of evidence in social care service and workforce development.

The ‘A Better Life’ programme has identified that relationships are key and ‘Often it is the simple things that bring the most pleasure (and the lack of them can bring a sense of sadness and loss) and services do not always seem to be very good at delivering ‘the ordinary’’. (Blood, 2013 p13)

The research challenges also call for a different way of working, which is often alien to the world of emotionally detached and compliance focussed task based care, which is summed up nicely in the following quote by Edgar Cahn:

‘The world of helping others in need is now built around one-way transactions…. and with the best of intentions, one-way transactions often send two messages unintentionally. They say: “We have something you need – but you have nothing we need or want or value.”’  (Cahn, 2004).

In a series of recent focus groups and learning events involving older people, carers and frontline staff, I have been struck by how many people feel that current regulation and guidance is risk averse restrictive and at worst destructive of human relationships. For example, workforce regulation states ‘the inappropriate use of touch is not permissible’, rather than ‘the appropriate use of touch is fabulous and to be encouraged’. This is a particular issue for people living with dementia, who often have to express themselves and connect with others through feelings and emotions. Frontline staff talk have talked about feeling guilty when they do little kind things that are not written in the Care Plan or receiving small gifts of appreciation, older people have been ‘told off’ (in the name of health and safety) for pouring tea for others in day services, and carers have been made to feel that they no longer have a role when the person they love goes into a care home.

At the heart of co-production, is an understanding that everyone has something to contribute and that exchanging these contributions is enriching for everyone concerned.  I am reminded of the work of Jean Vanier, who established the L’Arche Communities in learning disability services. Vanier did not see his role as caring for people with learning difficulties, but rather sharing his life with them and being open to receive and learn from them as much as to offer them support.

I am reminded of one of my earliest experience of working in social care services. It was 1984 and I had started my first job as a residential support worker in a children’s home. I thought I was the ‘sorted one’ who was employed to help others. I worked hard to form good working relationships with staff and children in the home, but one boy, who had experienced a lot of hurt in his life, kept his emotional distance. As anyone who knows me well can tell you, I am not gifted in DIY or anything that involves fixing something mechanical. One day, I was trying to repair my bicycle (I did not drive at the time) and was getting nowhere fast. The boy walked past me and said ‘I’ve got a book about repairing bikes, do you want to borrow it?’. I am pleased to say that I took up his offer and our friendship took off from that day. He is now a happily married 43 years old who lives on the other side of the country, but we still keep in contact via Facebook and phone and offer each other support and encouragement whenever we can.

Jean Vanier once said, ‘I am struck by how sharing our weakness and difficulties is more nourishing to others than sharing our qualities and successes’. This is an important message for social care practitioners and agencies. We need to open our ears, our eyes and our hearts to the people we work with, which might involve sharing our vulnerabilities and concerns and allowing ourselves to be changed by genuinely ‘meeting’ with them in truly co-productive relationships.

 

References

Blood, I. A Better Life – Valuing Our Later Years, York, Joseph Rowntree Foundation, available at: http://www.jrf.org.uk/publications/better-life-valuing-our-later-years

Cahn, E. (2004), No more throw away people – the co-production imperative, Washington, Essential Books

Condemned as a ‘Typical’ Man?

By Robin Hadley

A few moths ago, I attended a seminar on infertility treatment. The audience included those involved in infertility treatment, academics, practitioners, and interested others. The complexities surrounding infertility treatment are vast and range from the very intimate and personal to legalities at national and international level. Conducting research in such a sensitive area is fraught with difficulties and the speakers were all very aware of the ethical implications of their research and practice. I was particularly interested in the researchers’ experience of accessing and interviewing men. The general view in infertility studies has been that men are not interested in participating in research, and many studies are heavily weighted with female respondents. As one researcher described her many efforts to interview the male partner of a couple, a ripple of sympathetic recognition of her struggle arose from the audience. ‘Typical man’ seemed to be the collective verdict, mine included. As I reflected back on the day I returned to that incident. The audience reaction was one of sympathy for the researcher and I wondered if that man did not also deserve some empathy. I know from my own research that many men assume that they will be fathers and that that knowledge is so embedded that it is not discussed. The assumption expressed has been that one would leave school, get a job/go to university/ get a job, find a partner, find accommodation, have children. That being the case I tried to put myself in that man’s position: the assumed ‘natural’ event had not happened. How would I feel? Shocked to the very core? I think so. Perhaps I had been brought up not to show feelings and instead, to show control – ‘mastery’ – through actions and/or rationality. In which case my reactions may include striving to balance things up by working and playing harder, or not becoming involved. Being raised in an environment where I am not expected to express emotions, I possibly, do not have the confidence or vocabulary to verbalise my emotional state. Here are my musings on what may have been ‘going on’ if I was that unwilling participant, “So, here I am, not fulfilling the role I expected to – and that others seem to achieve with ease – and I cannot make it right. There is only one person I can talk to and that is my partner but it is worse for her and the one thing I can be is strong for her. Then there is this University researcher who wants to have a talk. She’s talked to my partner, and wants to talk to us both. My partner thinks it will do me good. I don’t know how to express these feelings inside without bursting. I want to support my partner, part of me thinks it would be good to release the emotions but I can’t risk overwhelming her in the way I am sometimes overwhelmed. I’ll say I’ll do it and then see.”
If the participant’s thoughts and feelings were similar to the above then it is understandable why he was ambivalent about being interviewed.

Infertility has been seen as a form of complex bereavement consisting of multiple loses (Adler, 1991; Lechner et al., 2007) with levels of distress in women recorded as high as those suffering from serious medical conditions (Domar et al., 1992; Domar et al., 1993). However, recent research shows that, post infertility treatment, men who did not become fathers suffered poorer mental health than those who had become fathers (Fisher et al., 2010). In their conclusions Fisher et al (p.6) state ‘…that stereotypes that infertile men conflate fertility and masculinity, are less distressed than women about potential loss of parenthood, and adjust more readily to childlessness appear inaccurate.’ Men may or may not be ‘typical’ by choice but there are many social factors that influence their behavior and how their behavior is perceived. The belief that men are not interested in taking part in research, and their absence ‘condemned to be meaningful’ (Lloyd, 1996: p.451), reflects a lack of insight by the research community. I feel I must stress here these are my own reflections based on my research on involuntarily childless men and not a particular person or persons.

Useful websites
Infertility Network UK: http://www.infertilitynetworkuk.com
The Human Fertilisation & Embryology Authority: http://www.hfea.gov.uk/index.html
Mensfe: http://www.mensfe.net

References
Adler, N. E. (1991). Forward. In Stanton, A. L. & Dunkel-Schetter, C. (Eds.), Infertility: Perspectives from Stress and Coping Research (pp. vii-ix). Plenum Press: New York.
Domar, A., Broome, A., Zuttermeister, P. C., Seibel, M. & Friedman, R. (1992). The prevalence and predictability of depression in infertile women. Fertility and Sterility, 58, 1158-1163.
Domar, A. D., Zuttermeister, P. C. & Friedman, R. (1993). The psychological impact of infertility: a comparison with patients with other medical conditions. Journal of Psychosomatic Obstetrics and Gynaecology, 14(Special issue), 45-52.
Fisher, J. R. W., Baker, G. H. W. & Hammarberg, K. (2010). Long-term health, well-being, life satisfaction, and attitudes toward parenthood in men diagnosed as infertile: challenges to gender stereotypes and implications for practice. Fertility and Sterility, 94(2), 574-580.
Lechner, L., Bolman, C. & Van Dalen, A. (2007). Definite involuntary childlessness: associations between coping, social support and psychological distress. Hum. Reprod., 22(1), 288-294.
Lloyd, M. (1996). Condemned to be meaningful: Non-response in studies of men and infertility. Sociology of Health & Illness, 18(4), 433-454.

When Caring Goes Wrong: Rehoming Unowned Dogs

By Marie Fox

Those of us who share our lives with dogs know that interspecies relationships are an important and mutually enriching basis for caring practices, yet it is also evident that dogs are often victims of a complete lack of care. These extremes of care are vividly captured in the contrast between the casual cruelty of the 27 year old trainee solicitor sentenced to 18 weeks in prison last month for leaving her boxer dog to starve in a locked kitchen, and the tenacity with which homeless people cling to their relationship with their dogs notwithstanding the difficulties this may pose to them in finding a home. Paradoxical attitudes also characterise media responses to dogs. At the same time that television programmes celebrate The Wonder of Dogs, newspaper reports disproportionately depict dogs as out of control weapons or feral killers. In a familiar litany of reporting of dog attacks on humans, common features are a focus on breed, a desire to impose responsibility and a failure to address the root causes of our problematic relationship with dogs. Over the last few months this is evident in accounts in February 2014 of dog attacks in Blackburn, where an eleven month old girl, Ava-Jane Corless, was savaged as she slept in her bed by an American pit bull type dog owned by her mother’s boyfriend, in Carmarthenshire where Eliza-Mae Mullane, a six day old girl, died having being pulled from her pram and bitten by her family’s Alaskan Malamute who had been acquired from someone in a pub, and in Lincolnshire where in March another pit bull type attacked a 22 year old woman walking near an old quarry.

Malamutes and bull breeds figure disproportionately amongst the sheer numbers of unwanted dogs that are stretching the resources of local authorities, charities and dog rescues. The 2013 Annual Stray Dogs Survey by Dogs Trust reveals that 111,986 stray and abandoned dogs were picked up across the UK over the last 12 months, equating to 307 stray dogs being found every day. Many are bull breeds, victims of a process of media stereotyping fuelled by the 1991 Dangerous Dogs Act which in categorising pit bull terriers as dangerous dogs, has served to make all bull breeds perversely attractive to the wrong sort of owner. One particularly tragic case highlights the potential for well intentioned and caring actions to go wrong in the world of dog rescue. In November 2013 four year old Lexi Branson died after being mauled by her family’s dog Mulan. According to newspaper reports Lexi’s mother, Jody Hudson, fatally stabbed the dog in a frantic attempt to save her daughter when he attacked her on the floor of the lounge in their flat. It transpired that Mulan was an American bulldog type who had been adopted by Lexi’s mother in August 2013 from a Leicestershire rehoming centre. The rehoming reportedly took place after she had seen a picture of the dog in the rehoming section of the rescue’s facebook page. A friend of Ms Hudson reported that the dog had a soft nature and that Ms Hudson had been told he was safe around children. The rescue declined to comment. In the absence of all the facts it is important not to judge actions, as anyone involved in dog rescue will testify.

I volunteer with one of the many small dog rescues struggling to cope with Britain’s unwanted dogs. We work closely with a local authority pound in the North West of England to provide emergency kennel space for dogs who have not been reclaimed, rehomed or offered a rescue space within seven days. At this point they can lawfully be humanely destroyed under s 149 Environmental Protection Act 1990. A key aim of organisations like ours is to place our dogs with bigger and better resourced rescues. However, typically, due to their fear of being overrun with too many unwanted breeds, it falls to smaller rescues to rehome bull breeds – mostly Staffordshire Bull Terrier crosses. We homecheck for our dogs as carefully as possible, requiring prospective owners to complete forms, submit to a home visit, visit the dog in kennels and ensure that dogs are neutered and vaccinated prior to rehoming while dogs are not placed in a home with children under 10 years old. However a consequence of such conditions is that we lose out on good potential homes and in many cases prospective adopters will simply buy a puppy or adopt from a rescue too stretched to impose such conditions. And notwithstanding the care taken and great joy of waving a dog off to a new home, the process is inevitably accompanied with apprehension that things may go wrong, given the difficulties of adequately assessing dogs in a kennel environment.

However in the absence of the full story in most of these cases there are nevertheless a number of conclusions we can draw about media reporting and the reaction it has provoked which serve to highlight our flawed thinking about dogs. Initial media reports of the Branson case pictured Lexi with her uncle’s Dogue de Bordeaux who was erroneously deemed responsible for the attack and wrongly described as a French mastiff. The upshot was that breed specific rescues were reported in dogworld as having been inundated with calls from concerned owners wishing to give up their dogs. When pictures of Mulan were published, the immediate response of bull dog rescues was to deny that Mulan was a ‘British bulldog’, with an editorial in dogworld opining that “After some initial confusion, the dog responsible for this incident is now referred to as a bulldog even though it bears little resemblance to the pedigree Bulldogs bred in this country.” Such responses strike me as reflecting the manifold failures of social attitudes including UK law which casts dogs as disposable commodities and indiscriminately stigmatises certain dogs purely on the basis of their morphology or breed type. Media narratives which reify this focus on breed, and implicitly criticise the irresponsibility of a mother in choosing to allow into her home a dog of uncertain pedigree and origin, or rescues which somehow failed in an ill-defined area, obscure the root causes of indiscriminate breeding which produces unhealthy or ill socialised puppies, dangerous dogs legislation which has compounded the problems of unwanted and often traumatised bull breeds and a legal strategy of ascribing responsibility for stray and unwanted dogs to local authorities which are already struggling to fulfill their core responsibilities and are ill equipped to cope with the complexities of dealing with stray and dangerous dogs. Against this backdrop blaming a mother for her caring action in adopting a dog in need of a home, a not for profit organization struggling to fill the gaps in state provision or even the dog himself is manifestly ill conceived. Until our outdated and paradoxical legal attitudes to dogs are tackled, tragedies such as these unfortunately seem unavoidable, however much well intentioned individuals and dog rescues strive to care.

The Right to Assistance – The Public Duty to Assist by Jane Krishnadas

The Hands of the CLOCK; Rights as the Intersections

Since the Legal Aid Sentencing Punishment and Offenders Act, 2012 – ‘The Government’s evisceration of Legal Aid leaves those of us involved in the court system feeling a bit like the  inhabitants of an island about to be hit by a tsunami… (Saunders, The Lawyer, 2013).  Having lived, worked and researched in a post-disaster situation, the comparison may seem extreme. However, one year after LASPO, the collaborative efforts of the Community Legal Outreach Collaboration Keele, (CLOCK), have been just in time to assist more than 100 litigants a month facing the loss of livelihood, property or families, which replicated across the UK reaches the disaster scales of 100,000’s of people.

Theoretically, the comparison of the post-disaster sites lies in Arendt’s framework of diminished agency and a declining state (The Human Condition), within which I’ve explored the role of rights within different ‘Scales of Justice’ (Fraser), as a transformative rights strategy; reflecting voices, revaluing resources and relocating sites of justice; (Rights as the Intersections, A Transformative Methodology).

CLOCK

CLOCK Logo

The CLOCK logo presents a visual and practical blueprint of the interrelation of rights and duties within the local justice system (see CLOCK partner leaflet). The Community Legal Outreach Collaboration, Keele (CLOCK) was formed as an umbrella of professional public, private and third sector organisations, to develop a new role ‘the Community Legal Companion’, premised upon the McKenzie Friend principles,  to safeguard the litigant- in-person’s rights to assistance and access to legally-aided and affordable legal services, within the shared commitment to access to justice.

The Community Legal Companion is centred within CLOCK, reflecting Crenshaw’s principle ‘that those concerned with alleviating discrimination’ should begin with ‘addressing the needs and problems of those who are most disadvantaged… for which placing those who are currently marginalised in the centre is the most effective way to resist efforts to compartmentalise experiences’ (‘Demarginalising the Intersection of Race and Class’, Crenshaw, 1989; 167).

However the Legal Companion presents a different starting point to Martha Fineman’s ‘Vulnerable Subject’ (2008). The Legal Companion is an assistant to the legal subject, premised upon the right to reasonable assistance which is embedded within the McKenzie Friend Practice Guidance, July 2010. The text clearly affirms ‘The Right to Reasonable Assistance’. Critically the right of assistance is the right of the litigant. It is not a right of the gratuitous, commercial or politically motivated McKenzie Friend.

The Legal Companion cannot act as an agent for the individual and has no authority to act or speak or advise in any way on behalf of the individual. The litigant’s voice therefore remains their own, as does their actions and decisions- in the words of a litigant, the legal companion is ‘My Calm in the Storm’ (BBC Radio Stoke Discusses Legal Aid and CLOCK).

It is the duty of the court to grant the right of assistance, or provide sufficient reasons why the litigant should not receive assistance. The decision of the court is based upon procedural fairness, the right to a fair trial and the efficient administration of justice. The Chair of the Civil Justice Council Working Party on Access to Justice for litigants-in-person states ‘It is impossible to overstate how important it is for people to have access to justice in a free society”, and calls for ‘concerted leadership to drive collaboration’ (Civil Justice Council Calls for Action).

The CLOCK dial represents a collaborative shared duty to the right of assistance. The Courts provide training on the court forms for suspending evictions, debt, divorce and Children Act applications. The Police and CPS provide training on bridging the civil and criminal processes. The Charitable organisations, circle the CLOCK, providing supporting evidence for legal aid applications, and holistic support; the first quartile, housing and complex needs, Brighter Futures, ASPIRE; the second, family relations, YMCA Family Services, Arch, Savana, Voices of Experience;  the third, community safety, Savana and the fourth, welfare and discrimination, Staffordshire North and Stoke-on-Trent Citizens Advice Bureau, SNCAB. The inner circle of the partner law firms Nowell Meller, Salmons, Young and Co, Lichfield Reynolds and colleagues within the North Staffordshire Law Society‎, and Regent Chambers and Rowchester Chambers,  ensure the companion acts within the professional duty to refer to mediation, legally-aided and affordable legal services. (See: Law Society Litigant in Person, Practice Note; and Bar Society: Guide to Representing yourself in Court).

The legal companion, provides a holding hand, the hands of the clock, to pivot the range of public, private and third sector services, which intersect the complex nature of shattered lives (see Intersectionality and Beyond) for which legal companions have assisted clients to trace multiple legal pathways through criminal, civil, welfare, immigration and domestic violence services (BBC News, Keele students help legal aid gap).

The daily presence of the legal companions in the court, presents a mechanism to draw together evidence to satisfy legal aid criteria, monitor the scope and impact of LASPO on the local community and highlight cases to challenge the fairness of s.10, LASPO, as recommended in the R.1, R.3, and R.4, of the Low Commission Report, Jan 2014.

The hands of the CLOCK  reached the hour, when the Head of Legal Aid visited the domestic violence refuge and listened to ‘Voices of Experience’, to contribute their perspectives on access to legal aid to the  Parliamentary Debate on Baroness Scotland’s Civil Motion to Regret (Head of Legal Aid Commends Legal Companion CLOCK initiative, as “a really positive initiative and could provide a model for similar programmes across the country”).

The endorsement of CLOCK as: an ‘imaginative scheme’ from the Stoke-on-Trent Judiciary; ‘a strategic development in legal education’ (the HEA, Strategic Summit, 2014); an ‘excellent service which epitomises the practical implementation of several of the Working Party’s recommendations’, (Civil Justice Council) and a case study of ‘good practice’ within the Legal Services Consumer Panel Fact Finding Visit, has secured the interest for wider collaboration from Birmingham, Birmingham City and Wolverhampton Courts and Law Schools.

CLOCK has maintained its momentum via the pendulum of in-kind resources, exchanging the costs of court, police, CPS, solicitor barrister and local council time with the experience of the legal companion assistance to navigate the most direct and supported pathways to meet unmet legal needs.

As the past President of the Law Society concludes ‘Sadly the cuts are inevitable’ it may be important to remember the Public interest litigation (S. Krishnadas v Government of Maharashtra). Filed by the, then, law student who initiated the Social Legal Information Centre, Omerga, to fact find information, and with the support of the independent judicial inquiry on the constitutional right to equality won a High Court order for the State to provide financial compensation, housing and basic needs to the earthquake-affected population (see with Krishnadas Sukumaran, Reclaiming Rights, Pluto Press, forthcoming).

Twenty years on, the comparison may seem a travesty, with in effect, “the cessation of the ‘Legal Aid’ programme as it was and its evolution into a new mutation with centralised and commercial controls run from regional centres”, yet the provision of a local service (CLOCK) with “access to citizens in the community will become a resource of huge importance for those who rely on the use of the national legal system. The City which holds the ‘signed’ Magna Carta should also seek to set an example of the standards of performance expected of that document” (David Hallmark, CBE, Worcester Law Society, Visiting Fellow, Oxford. See 2015: Unification of the four surviving original copies of the Magna Carta, celebrating the 800th anniversary of the issue of the Charter).

It is at this intersection in time, where the hands of the CLOCK may indicate a potential for ‘remaking and restructuring the world’, (Crenshaw, 1989; 167)… or at least to bridge our constitutional rights and duties within local spheres of justice… time will tell.

Please note that with due regard to the wider CLOCK partnership, this is a personal narrative of my experience and views. For further information please contact j.h.krishnadas@keele.ac.uk

Psychiatric institutionalization, femininity, and women’s care giving in Poland

by Agnieszka Doll

Mental illness is often associated with notions of irrationality, unpredictability, and the imaginary threat of violence or possible negligence. For women who have been institutionalized in psychiatric hospitals, the stigma placed upon them takes on a polymorphous status as “mad” and “bad,” directly interfering with normative regimes of femininity. Particularly in societies like Poland with a traditional patriarchal gender order, these women may be seen as “unfit” mothers and “troublesome” wives, disruptive to the “normal” functioning of their families. The cultural script of Polish women as mothers and the primary care-givers cuts across class, profession, and place (Czerwinska, A., Lapniewska, Z., and Piotrowska, J., 2010) .Yet, for women with histories of psychiatric hospitalization, those care giving roles are denied. The Polish Public Opinion Research Center (CBOS) in 2008 and 2012 conducted surveys which show constant agreement among respondents that women with mental illness and previous hospitalization – regardless of the details of their individual prognoses – should be excluded from care taking duties for minors. This impacts both their private and professional lives as, for example, they may be denied employment as nannies or teachers. Even though the survey did not ask whether respondents perceived previously hospitalized women to be “fit” mothers, it illuminated the extent to which stigma of mental illness and institutionalization bears on women’s ability to fulfil societally assigned gender roles. Given that, women with histories of psychiatric hospitalization may experience difficulties in winning custody of their children in family law cases, for instance. When they manage to gain or uphold custody in such cases, to resist future hospitalization and to uphold their care-giving responsibilities they may need to drastically change their daily lives in an attempt to provide “proof” of their sanity (interpreted as orthodox compliance with gender norms) to state agencies, professionals or broader society. Thus, psychiatric examination and classification, particularly when imposed on women who are committed unwillingly, can function as a form of societal and institutional surveillance.

In spite of these serious implications, the process of admission to psychiatric facilities remains under-analysed. Current scholarship generally revolves around the need to find a balance between respect for personal liberties and the state’s right to protect the public from “dangerous” and “mentally ill” individuals. As well, it focuses on the negotiation of treatment needs and legal standards of due process within the context of admission. My doctoral research, designed as an institutional ethnographic study (D. Smith, 2006), aims to explore the procedure of involuntary psychiatric institutionalization of women in Poland, particularly its social organization. This is to gain a broader understanding of how knowledge about women as “pathological” subjects is produced within the process of psychiatric admission, and how this knowledge production occurring in local sites is organized and coordinated by ideological discourses, texts, and the features of organizational contexts. One of the project’s aims is to disrupt the mega-narrative of the official and “authoritative” accounts of psychiatric and legal professionals produced in involuntary admission processes that silence women’s voices and experiences. It is hoped that by illuminating how accounts of “pathological” women are produced within everyday institutional practices the notion of institutionalized women as “mad” and “bad” would be problematized.

References:

Czerwinska, A., Lapniewska, Z., & Piotrowska, J. (2010). Kobiety na “zielonej wyspie”: Kryzys w Polsce z perspektywy gender. Warszawa: Fundacja Feminoteka.

Omyla-Rudzka, M. (2012). Stosunek do chorych psychicznie. Warszawa: Fundacja Centrum Badania Opinii Spolecznej.

Smith, D. (2006). Institutional ethnography as practice. Lanham, Md.: Rowman &n Littlefield.

Wciorka, B., & Wciorka, J. (2008). Osoby chore psychicznie w spolecznstwie: Komunikat z badan. Warszawa: Fundacja Centrum Badania Opinii Spolecznej.

Agnieszka Doll is a PhD Candidate at the Faculty of Law, University of Victoria in Canada. Currently she is a Visiting Doctoral Fellow at the Bielefeld Graduate School in History and Sociology, University of Bielefled in Germany.