Social representations of mental illness: A study of British and French mental health professionals.

Based on the theory of social representations, the thesis explores how mental health professionals understand mental illness. The principle data source for this investigation is semi-structured interviews conducted with sixty mental health professionals in Britain and France, two countries currently moving towards community-based care for the mentally ill. Systematic qualitative analysis of these interviews (using QSR-NUDIST) is both grounded in the data and guided by previous research findings, theoretical considerations, and other data sources (policy documents and observations). Research explores how the nature, causes and treatment of mental ill health are represented by professionals, and provides an empirical test of the concept of 'professional social representations'. These are conceived as professional practitioners' representations of the object of their work, which consist of five inter-related elements: practice, theory, professional identities, organisational factors and lay representations. Analysis highlights how, despite their 'expert' status, mental health professionals adopt an agnostic stance and their representations are fraught with uncertainty, questioning and debate. Mental illness is understood as a polymorphous category, broadly divided into 'neuroses' and 'psychoses' and understood in essentially social terms. Thus, various forms of difference, distress and disruption are central themes. Professional practice is conceptualised as a social rather than medical endeavour, which involves eclectic interventions in many aspects of clients' daily lives. The dominant role in France of psychodynamic theories and practices is the only major difference between professionals in France and Britain. With contemporary shifts towards community-based care, practitioners experience added uncertainties and difficulties in renegotiating professional working relationships. The findings suggest that professional social representations serve important compromise functions, helping the practitioner community to reconcile the tensions and conflicting agendas of mental health work, and reflecting the unique role of professionals in the development and circulation of social knowledge. This research extends the scope of application and the conceptualisation of the theory of social representations