Faculty of Social Sciences, School of Social Work, Lund University, 22100 Lund, Sweden.
Int J Environ Res Public Health. 2023 Jul 22;20(14):6427. doi: 10.3390/ijerph20146427.
Working actively to engage service users in participatory practices is both a policy expectation and a moral imperative for mental health social workers in contemporary Western mental health care. Recent research suggests that such practices of service user involvement are becoming increasingly individualised and driven by market logic. Based on an ethnographic study within a Swedish public psychiatric organisation, this article applies the concept of commodification to examine this trend. By showing how the practice of user involvement takes the form of a market where personal narratives and experiences of mental health problems are bought and sold as commodities, the analysis illuminates how market logic permeates the everyday practice of user involvement. One consequence of this commodification is that user organisations, as well as individual service users, are restricted in their role as independent actors pursuing their own agenda, and instead increasingly act on behalf of the public and as providers of personal experiences. While it is vital that service user perspectives are heard and recognised within mental health services, mental health social workers need to be aware of the risks of commodifying lived experience. When attention is directed to individual experiences and narratives, there is a risk that opportunities to advocate on behalf of the user collective as a whole and speak from a more principled and socio-political standpoint are lost. In addition, the commodification of personal experience tends to rationalise and privilege user narratives that conform to the dominant institutional logic of the mental health organisation, while excluding more uncomfortable and challenging voices, thereby undermining the ability of service users to raise critical issues that do not align with the interests of the mental health organisation.
积极促使服务使用者参与参与式实践，既是当代西方心理健康护理中精神健康社会工作者的政策期望，也是道德要求。最近的研究表明，这种服务使用者参与的实践正变得越来越个体化，并受到市场逻辑的驱动。本文基于对瑞典一家公共精神卫生组织的民族志研究，运用商品化概念来检验这一趋势。通过展示用户参与实践如何采取市场形式，将心理健康问题的个人叙述和经验作为商品进行买卖，分析揭示了市场逻辑如何渗透到用户参与的日常实践中。这种商品化的一个后果是，用户组织以及个别服务使用者在追求自身议程方面作为独立行为者的角色受到限制，而是越来越代表公众并作为个人经验的提供者行事。虽然在心理健康服务中听取和认可服务使用者的观点至关重要，但精神健康社会工作者需要意识到将生活经验商品化的风险。当注意力集中在个人经验和叙述上时，就有可能失去代表整个用户集体进行倡导并从更有原则和社会政治立场发言的机会。此外，个人经验的商品化往往使符合精神卫生组织主导制度逻辑的用户叙述合理化和特权化，而排除了更不舒服和具有挑战性的声音，从而削弱了服务使用者提出不符合精神卫生组织利益的关键问题的能力。
