To tell the right story: Functions of the personal user narrative in service user involvement

From the starting point of narrative ethnography, this article explores a specific kind of service user involvement in psychiatry: staff training activities in which patients and former patients are invited to “tell their stories”. A core feature of these stories is that they are based on the narrators’ self-perceived experience, and they all have a highly personal character. I call these stories service user narratives, and these are the topic of study in this article. The narratives’ disposition, content and functions are explored, as is the role played by the personal aspects of the stories. This article investigates two functions of the service user narrative: the narrative as a means (1) of creating alternative images of mental ill health, and (2) of enabling a critique of psychiatry. The context wherein the stories are told can be understood as containing an inherent power asymmetry, in which the narrators hold a subordinate position relative to the organization and its employees. Hence, the study explores how power structures affect and might be affected by the user narratives. It turns out that while the user narratives work as counter-narratives in some respects, questioning the dominant order, in other ways they maintain the current power balance within psychiatry. The personal features of the user narrative are vital to enabling the delivery of a critique — however, at the same time, the same personal features could also work to help maintain the narrator’s inferior position