IDEAS home Printed from https://ideas.repec.org/a/pal/palcom/v4y2018i1d10.1057_s41599-018-0091-y.html
   My bibliography  Save this article

Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform

Author

Listed:
  • Felicity Thomas

    (University of Exeter)

  • Lorraine Hansford

    (University of Exeter)

  • Joseph Ford

    (University of Exeter)

  • Katrina Wyatt

    (University of Exeter)

  • Rosemarie McCabe

    (University of Exeter)

  • Richard Byng

    (University of Plymouth)

Abstract

Associations between mental health and poverty are increasingly well established. Yet in neoliberally oriented contexts in which distress engendered through the everyday hardships of poverty is increasingly pathologised and medicalised, important questions are raised over the assumptions inherent within mental health policy and its implementation. Using the UK as a focus, this paper reviews and maps out key questions that require investigation in order to better understand the complex inter-relations between poverty and distress; explores how current paradigms might influence notions of individual responsibility and agency as well as health seeking behaviours; and examines the role of, and cultural and systemic expectations and constraints placed upon GPs as they respond to distress amongst patients from low-income communities. In so doing, we argue for recognition of the moral narratives that underpin both mental health care and processes of welfare reform, and call for an expansion of conventional notions of evidence-based healthcare to incorporate the understandings, experiences and priorities of people from low-income groups. We call for more detailed questioning and analysis of the interactions that lead to mental health diagnosis and treatment and better understanding of the relevance and effectiveness of current treatment options. As a central tenet of this, we argue for more flexible and nuanced healthcare responses that better reflect the dynamic and multi-faceted nature of poverty-related distress.

Suggested Citation

  • Felicity Thomas & Lorraine Hansford & Joseph Ford & Katrina Wyatt & Rosemarie McCabe & Richard Byng, 2018. "Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform," Palgrave Communications, Palgrave Macmillan, vol. 4(1), pages 1-8, December.
    • Handle: RePEc:pal:palcom:v:4:y:2018:i:1:d:10.1057_s41599-018-0091-y
    DOI: 10.1057/s41599-018-0091-y
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1057/s41599-018-0091-y
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1057/s41599-018-0091-y?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Barr, Ben & Kinderman, Peter & Whitehead, Margaret, 2015. "Trends in mental health inequalities in England during a period of recession, austerity and welfare reform 2004 to 2013," Social Science & Medicine, Elsevier, vol. 147(C), pages 324-331.
    2. Irving Kirsch & Brett J Deacon & Tania B Huedo-Medina & Alan Scoboria & Thomas J Moore & Blair T Johnson, 2008. "Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration," PLOS Medicine, Public Library of Science, vol. 5(2), pages 1-9, February.
    3. Seale, Clive & Rivas, Carol & Al-Sarraj, Hela & Webb, Sarah & Kelly, Moira, 2013. "Moral mediation in interpreted health care consultations," Social Science & Medicine, Elsevier, vol. 98(C), pages 141-148.
    4. Reiss, Franziska, 2013. "Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review," Social Science & Medicine, Elsevier, vol. 90(C), pages 24-31.
    5. Hansen, Helena & Bourgois, Philippe & Drucker, Ernest, 2014. "Pathologizing poverty: New forms of diagnosis, disability, and structural stigma under welfare reform," Social Science & Medicine, Elsevier, vol. 103(C), pages 76-83.
    6. Ellis, J. & Boger, E. & Latter, S. & Kennedy, A. & Jones, F. & Foster, C. & Demain, S., 2017. "Conceptualisation of the ‘good’ self-manager: A qualitative investigation of stakeholder views on the self-management of long-term health conditions," Social Science & Medicine, Elsevier, vol. 176(C), pages 25-33.
    7. Wheat, Hannah C. & Barnes, Rebecca K. & Byng, Richard, 2015. "Practices used for recommending sickness certification by general practitioners: A conversation analytic study of UK primary care consultations," Social Science & Medicine, Elsevier, vol. 126(C), pages 48-58.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Charlotte Meilstrup & Lau Caspar Thygesen & Line Nielsen & Vibeke Koushede & Donna Cross & Bjørn Evald Holstein, 2016. "Does self-efficacy mediate the association between socioeconomic background and emotional symptoms among schoolchildren?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(4), pages 505-512, May.
    2. Karimli, Leyla & Ssewamala, Fred M. & Neilands, Torsten B. & Wells, Christine R. & Bermudez, Laura Gauer, 2019. "Poverty, economic strengthening, and mental health among AIDS orphaned children in Uganda: Mediation model in a randomized clinical trial," Social Science & Medicine, Elsevier, vol. 228(C), pages 17-24.
    3. Schreier, Alayna & Stenersen, Madeline R. & Strambler, Michael J. & Marshall, Tim & Bracey, Jeana & Kaufman, Joy S., 2023. "Needs of caregivers of youth enrolled in a statewide system of care: A latent class analysis," Children and Youth Services Review, Elsevier, vol. 147(C).
    4. Yekaterina Chzhen & Irene Moor & William Pickett & Emilia Toczydlowska & Gonneke Stevens & UNICEF Innocenti Research Centre, 2016. "Family Affluence and Inequality in Adolescent Health and Life Satisfaction: Evidence from the HBSC study 2002-2014," Papers inwopa836, Innocenti Working Papers.
    5. Wong, Sandy, 2016. "Geographies of medicalized welfare: Spatial analysis of supplemental security income in the U.S., 2000–2010," Social Science & Medicine, Elsevier, vol. 160(C), pages 9-19.
    6. Klocke, Andreas & Stadtmüller, Sven, 2024. "Two generations later: New evidence on health equalisation in youth," Social Science & Medicine, Elsevier, vol. 342(C).
    7. Anson Au, 2023. "Reassessing the econometric measurement of inequality and poverty: toward a cost-of-living approach," Palgrave Communications, Palgrave Macmillan, vol. 10(1), pages 1-10, December.
    8. Bennett, Davara L. & Webb, Calum J.R. & Mason, Kate E. & Schlüter, Daniela K. & Fahy, Katie & Alexiou, Alexandros & Wickham, Sophie & Barr, Ben & Taylor-Robinson, David, 2021. "Funding for preventative Children’s Services and rates of children becoming looked after: A natural experiment using longitudinal area-level data in England," Children and Youth Services Review, Elsevier, vol. 131(C).
    9. T. Gregory & E. Dal Grande & M. Brushe & D. Engelhardt & S. Luddy & M. Guhn & A. Gadermann & K.A. Schonert-Reichl & S. Brinkman, 2021. "Associations between School Readiness and Student Wellbeing: A Six-Year Follow Up Study," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 14(1), pages 369-390, February.
    10. Yu-Chun Lin & Yu-Hung Chang & Huang-Ting Yan, 2020. "Is trade a blessing or a curse? A panel data analysis of the determinants of depressive disorders," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(7), pages 1113-1121, September.
    11. Whittle, Henry J. & Palar, Kartika & Hufstedler, Lee Lemus & Seligman, Hilary K. & Frongillo, Edward A. & Weiser, Sheri D., 2015. "Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: An example of structural violence in United States public policy," Social Science & Medicine, Elsevier, vol. 143(C), pages 154-161.
    12. Kim, Yeonwoo & Padilla, Yolanda C. & Zhang, Anao & Oh, Sehun, 2018. "Young children's internalizing and externalizing behaviors after mothers exit welfare: Comparisons with children of non-welfare mothers," Children and Youth Services Review, Elsevier, vol. 86(C), pages 316-323.
    13. Yang, Lawrence H. & Chen, Fang-pei & Sia, Kathleen Janel & Lam, Jonathan & Lam, Katherine & Ngo, Hong & Lee, Sing & Kleinman, Arthur & Good, Byron, 2014. "“What matters most:” A cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma," Social Science & Medicine, Elsevier, vol. 103(C), pages 84-93.
    14. Weisz, George & Knaapen, Loes, 2009. "Diagnosing and treating premenstrual syndrome in five western nations," Social Science & Medicine, Elsevier, vol. 68(8), pages 1498-1505, April.
    15. Aino I Saarinen & Dacher Keltner & Henrik Dobewall & Terho Lehtimäki & Liisa Keltikangas-Järvinen & Mirka Hintsanen, 2021. "The relationship of socioeconomic status in childhood and adulthood with compassion: A study with a prospective 32-year follow-up," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-16, March.
    16. Thompson, Laura K. & Sugg, Margaret M. & Runkle, Jennifer R., 2018. "Adolescents in crisis: A geographic exploration of help-seeking behavior using data from Crisis Text Line," Social Science & Medicine, Elsevier, vol. 215(C), pages 69-79.
    17. Salhi, Bisan A., 2020. "Who are Clive's friends? Latent sociality in the emergency department," Social Science & Medicine, Elsevier, vol. 245(C).
    18. Thomas Leoni & René Böheim, 2018. "Fehlzeitenreport 2018. Krankheits- und unfallbedingte Fehlzeiten in Österreich – Präsentismus und Absentismus," WIFO Studies, WIFO, number 61487, March.
    19. Klaus Munkholm & Stephanie Winkelbeiner & Philipp Homan, 2020. "Individual response to antidepressants for depression in adults-a meta-analysis and simulation study," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-16, August.
    20. Ad. J. W. van de Gevel & Charles N. Noussair, 2013. "The Nexus between Artificial Intelligence and Economics," SpringerBriefs in Economics, Springer, edition 127, number 978-3-642-33648-5, June.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pal:palcom:v:4:y:2018:i:1:d:10.1057_s41599-018-0091-y. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: https://www.nature.com/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.