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包容是同化、整合还是收编?通过同伴支持的心理健康研究来考察包容的产生——后结构分析。

Inclusion as Assimilation, Integration, or Co-optation? A Post-Structural Analysis of Inclusion as Produced Through Mental Health Research on Peer Support.

机构信息

School of Allied Health, Curtin University, Perth, WA, Australia.

出版信息

Qual Health Res. 2023 May;33(6):543-555. doi: 10.1177/10497323231163735. Epub 2023 Mar 20.

Abstract

In the last 20 years, research on the inclusion of peer support within mental health settings has burgeoned, paralleling the broad adoption of service user inclusion within policy as a moral imperative and universally beneficial. Despite the seemingly progressive impetus behind inclusion, increasingly peer support workers talk of exhaustion working within mental health systems, the slow rate of change to oppressive values and practices, and ongoing experiences of workplace exclusion. Such experiences suggest differences in the way in which inclusion is produced across different stakeholder groups and contexts. In this article, we adopt Bacchi's 'what's the problem represented to be?' approach to identify how mental health research, often understood as an a-political activity, produces versions of inclusion. We argue current research predominantly produces inclusion as 'assimilation' and 'integration'. We use critical inclusion, mental health, and survivor scholarship to evaluate the effects these productions have for peer support and peer support workers, finding that both problematise peer support workers and those seeking support. We consider possibilities for more liberatory productions of inclusion, building on the notion of inclusion as 'co-optation'. Our analysis points to the need for researchers to engage with an uncomfortable reflexivity to enable more emancipatory possibilities regarding inclusion and peer support.

摘要

在过去的 20 年中,关于将同伴支持纳入心理健康环境的研究蓬勃发展,这与将服务使用者纳入政策作为道德义务和普遍有益的做法相一致。尽管包容背后似乎有积极的动力,但越来越多的同伴支持工作者表示,在心理健康系统中工作感到疲惫不堪,压抑价值观和做法的改变速度缓慢,以及持续面临工作场所排斥的经历。这些经历表明,在不同的利益相关者群体和背景下,包容的产生方式存在差异。在本文中,我们采用 Bacchi 的“问题被表述为了什么?”方法来确定心理健康研究(通常被理解为一种非政治性的活动)如何产生包容的版本。我们认为,当前的研究主要将包容视为“同化”和“整合”。我们使用批判性包容、心理健康和幸存者研究来评估这些成果对同伴支持和同伴支持工作者的影响,发现这两种成果都使同伴支持工作者和寻求支持的人面临问题。我们考虑了更具解放性的包容生产的可能性,建立在包容作为“同化”的概念之上。我们的分析指出,研究人员需要进行不舒服的反思性思考,以便为包容和同伴支持带来更解放的可能性。

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