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置于不稳定之中:英国精神卫生保健领域变化中的准入与归属。

Placing precarity: access and belonging in the shifting landscape of UK mental health care.

机构信息

Institute of Public Health, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SR, UK.

出版信息

Cult Med Psychiatry. 2021 Mar;45(1):22-41. doi: 10.1007/s11013-020-09683-5.

Abstract

This paper engages with the notion of 'embodied belonging' through an ethnography of the social and material aspects of accessing mental health care in the UK. I focus on moments of access and transition in a voluntary sector organisation in London: an intercultural psychotherapy centre, serving a range of im/migrant communities. Whilst both 'belonging' and 'place' are often invoked to imply stability, I explore how material contexts of access and inclusion can paradoxically be implicated in the ongoing production of precarity-of unstable, uncertain, and vulnerable ways of being. A sociomaterial analysis of ethnographic material and visual data from two creative mapping interviews attends to material and spatial aspects of the centre and its transitory place in the urban environment. It demonstrates how these aspects of place became entangled in client experiences of access: uncertainties of waiting, ambivalence towards belonging to a particular client group, and questions around deservingness of care. This engendered an embodied and situated experience of 'precarious belonging'. I therefore argue that precarity should be 'placed', both within the concept of embodied belonging, and ethnographically, within the material constraints, impermanence, and spatial politics of projects to include the excluded in UK mental health care.

摘要

本文通过对英国获取心理健康护理的社会和物质方面的民族志研究,探讨了“具身归属感”的概念。我关注的是伦敦一个志愿组织——一个跨文化心理治疗中心——在获取和过渡时刻的情况,该中心为一系列移民社区提供服务。虽然“归属感”和“地方感”通常被用来暗示稳定性,但我探讨了物质环境的可及性和包容性如何会矛盾地涉及到不稳定性、不确定性和脆弱性的持续产生。对来自两次创意制图访谈的民族志材料和视觉数据进行的社会物质分析,关注了该中心及其在城市环境中的过渡性场所的物质和空间方面。它表明,这些场所方面是如何与客户的可及性体验纠缠在一起的:等待的不确定性、对特定客户群体归属感的矛盾心理,以及对护理的值得性的质疑。这产生了一种“脆弱归属感”的具身和情境体验。因此,我认为,在英国心理健康护理中,将被排斥者包容进来的项目的物质限制、短暂性和空间政治,既应在具身归属感的概念中,也应在民族志中“定位”脆弱性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1ee/7868314/2b58fb0998a7/11013_2020_9683_Fig1_HTML.jpg

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