Realising Our Best Intentions: Vision, Values and Voice in Community Non-government Organisations of the Aotearoa \New Zealand Mental Health Sector

This thesis examines the effectiveness of establishing a recovery orientation in community, non-government, mental health organisations in Aotearoa\New Zealand. It addresses the discursive constructions of key concepts such as madness, recovery and community care. In addition, it examines the wider, societal and institutional pressures that influence how important features of a recovery discourse, such as empowerment and an ordinary life in community, are articulated and enacted within organisational environments. It also investigates how institutional hegemonies are contested, and opportunities identified for institutional change and organisational transformation. Critical and postmodern perspectives in healthcare provided a rationale for utilising the framework for organisational communication research, developed by Dennis Mumby and Cynthia Stohl (1996, 2007). The framework addressed the problematics of (1) voice, (2) rationality, (3) the relationship between organisations and the state, as well as (4) the problematic of organising itself. Critical Appreciative Inquiry (Grant & Humphries, 2006) was the methodology used for this project. Focus groups and interviews facilitated dialogue among support workers, team leaders and senior managers from a range of community mental health organisations throughout Aotearoa\New Zealand. These encounters encouraged conversations about what worked well in organisations, and how to enhance a recovery-orientation, without shying away from a critical analysis of what was impeding best practice. The dialogues also enabled examination of how these organisations were situated within the larger socio-political and cultural environment. The findings of the study showed that organisational stakeholders constructed and translated the discourses of madness, illness and recovery very differently. Translations reflected the relative power of particular discourse communities, with powerful groups able to control meaning systems through their greater social legitimacy. Institutionalised discourses of biomedicine and managerialism proved difficult to “deinstitutionalise”, and institutional agents “translated” recovery discourses in ways that ensured little disruption to powerful and privileged interests. In addition, it was apparent that institutions undertook defensive institutional work when challenged. Defensive strategies were primarily discursive, e.g. translation, but were important mechanisms through which institutional interests subsumed alternative discourses, and maintained power over an organisational field. This thesis contributes to the field of organisational communication by demonstrating that perceptions of organisational, and institutional change, are frequently discursive, rather than substantive. Effective organisational change, therefore, needs to challenge institutional structures and systemic relationships of power. Sustained, and sustainable, change requires fundamental shifts in the rational bases of institutional logics. This has important implications for how less powerful actors and organisations can establish alternative discourses in institutionalised fields, such as mental healthcare