the Discourse-Historical approach

Picture from a cool article by T. Mills Kelly at The Conversation

In the chapter "Linguistic Analyses of Language Policies", Ruth Wodak suggests that a discourse analysis method can be helpful in studying language policies (2006: 170-193), so I decided I would try to implement this in my research. To prepare, I read How To Do Critical Discourse Analysis by David Machin and Andrea Mayr (2012).

One thing that has become clear from reading the book is that Wodak's approach is much more extensive and thorough than that described by Machin and Mayr. They see her work as an extension of an approach that is already a bit wider than the "common" critical discourse analysis (CDA) method, namely Van Dijk's socio-cognitive approach. In the "common" method, as described by Machin and Mayr, a few texts are picked out that are deemed representative of a particular kind of discourse by the analyst. He or she then analyses what semiotic choices are made that conceal the underlying ideology of the text. The purpose of CDA is to bring out and challenge hidden power relations, which they believe are created and reinforced through language and through specific discourses.

In my post on "discourse dissemination across social boundaries" I  talked about some of my hesitations with this approach, such as that it did not take into account who produced the text for which kinds of readers, and how those readers react to it. The conclusion of Machin and Mayr's book actually goes into these kinds of criticisms; that it does not consider the background and context of the production and consumption of the texts, on the one hand, and that it is too selective and subjective on the other hand.

In the discourse-historical approach described by Wodak, these issues are resolved to an extent. Background reasearch and ethnography are used to provide the actual context and history of certain discourses, to understand how they come about and what function they serve. Because of the large amount of data that are gathered, the selection problem of CDA is less acute of a problem. CDA becomes less of a focus on its own and more of a tool used to show how the discourses work in practice. It is also suggested that quantitative analysis (e.g. Corpus-based) be integrated, which would make the interpretation less subjective.

As a whole the approach probably makes for a PhD-size project per proper implementation. The next step for me is to think about how I could realistically integrate this into my own project. I'm now interested in ethnography and corpus linguistics though, and I'll be reading up about those. Also for next week I will try to apply my new CDA knowledge onto some of the articles I posted on here before.

Die Urmutter von Kartoffeln

Picture by Jim Richardson taken from AMNH

Das Kartoffel wurde im 16. Jahrhundert von Spanischen Seefahrern in Süd-Amerika entdeckt. Dort wurde es schon viele Jahrhunderten kultiviert, ebenso wie Maïs, Bohnen, Zwiebeln, Tomaten und Schokolade. DNA-Forschung hat gezeigt, dass alle Kartoffeln in Europa von einem Pflanz aus Süd-Peru abstammen: nur einem Pflanz, der wirklich die Urmutter von Kartoffeln geworden ist. Seitdem entstanden viele verschiedene Rassen. Aber im Süd-Amerika gibt es dennoch viel merkwürdiger Varianten: Rot, Schwarz, geformt wie ein Halbmond oder mit Beulen überall.

Als der Kartoffel in Europa introduziert war gab es zuerst viel Misstrauen. Die Kartoffel ist nicht in der Bibel erwähnt und die Menschen waren sich nicht sicher das sie von Gott zugelassen worden. Sie waren auch zögerlich, wurzeln zu essen von einen hochgiftigen Pflanz. Für zwei Jahrhunderten wird das nur von die armsten Leuten und von Schweine gegessen. Aber weil die Kartoffel in raue Bedingungen überleben kann und auch nicht slecht schmeckt, hat es sich langsam mehr akzeptiert. Heute isst der Welt Jahrlich etwa 200 Millionen Tonnen Kartoffeln.

Das besondere von der Kartoffel ist, das es in unendlich vielfältiger Weise angewendet werden kann. Mann kan es kochen, backen, braten, oder zu Suppe oder Brei machen. In Europa kennen wir natürlich alle Pommes Frites, Bratkartoffeln und Kartoffelsalat. In Nord-Irland macht man auch Brot von Kartoffeln; man fügt einfach etwas Mehl im Kartoffelbrei zu und backt es einige Minuten in einer Pfanne. In Schweden hat ein Hotel der “Hasselback”-Kartoffel erfunden: ein Bratkartoffel, aber geschnitten wie ein Fächer, mit ein knüspriges Resultat zu gefolg. Und im eigentlichen Nährboden, Süd-Amerika, isst man gerne Kartoffel-überasschungsknödeln, aus Kartoffelbrei mit scharfen Soße in der Mitte.

Discourse dissemination across social boundaries

Picture by brooklynpix

Having embarked on the mission to find out how to do Critical Discourse Analysis, it was nice to find out that one of the staff of the School of English and a former teacher of mine, Dr Mayr, has recently brought out a book with exactly that as the title. I've borrowed it from the library (a hassly affair as it is only available as a short loan, which has me running to the library through the rain at 3:45pm to return it before I get fined at exactly 4pm) and eventually decided to purchase it as it's useful and because I feel a sense of pride at owning books from people who have taught me.

The book intends to show precisely how the "semiotic choices" authors make (authors here referring to journalists and writers as well as photographers, singers, visual editors and whoever engages in communication) are influenced by and feed into discourses, or frameworks of interpretation, which are in turn ways to obscure the ideology of the text. These ideologies form the hegemony of the higher classes, and eventually serve to convince the lower classes that the way the higher classes control and oppress them is in fact legitimate. 

Let me first say that the book does a really good job of showing how these semiotic choices work. I will be writing more on this later as I will most likely be basing a lot of the analysis I'm going to do on what's explained in the book. As of yet I am working my way through it to form a sort of plan for how to do the analysis. 

So although I really do admire the minute detail they go into when analyzing texts, some of the underlying ideology shall we call it irks me to the max. The idea that - even in a democracy - the higher/educated/managerial classes, the ABC, control the lower and working classes, the DE, through the media (such as the Daily Mail which a lot of the examples in the book are drawn from) is in fact almost belittling as it implies that the lower classes have very little agency of their own. 

This is a quote from the book:

Power comes from privileged access to social resources such as education, knowledge and wealth, which provides authority, status and influence to those who gain this access and enables them to dominate, coerce and control subordinate groups. (...)

Power can be more than simple domination from above; it can also be jointly produced when people are led to believe that dominance is legitimate in some way or other. (...)

Power, at least in democratic societies, needs to be seen as legitimate by people in order to be accepted, and this process of legitimation is generally expressed through language and other communicative systems. (Machin and Mayr, 2012: 25)

To do a little analysis here; in the second part of the quote "people" are an object of a passive verb: they are led to believe that the dominance is legitimate rather than that they just believe it, which would imply more agency on their part. Who is the implied actor here? Who leads them to believe it? With reference to the first part of the quotation, it is suggested that "those who gain this access" are the ones who lead the "people" on and who are apparently not "people" themselves. Also, "dominance" could have been phrased in a more neutral manner, as "reign", "regime" or "government". Dominance is a very charged word which implies that the one group is controlling the other. The rather explicit suggestion throughout is that those who have money and who are educated are controlling and coercing the poor and the uneducated.

However if we are talking about how the higher classes control the lower through ideology, then it makes no sense that most of the examples in the analysis are from a paper (the Daily Mail) that espouses views almost exclusively held by the lower classes, as opposed to the Guardian or the Times, which communicate ideas more popular with the higher and middle classes. Clearly there is a question here about who actually writes the articles; who communicates these ideologies and why is it in their interest to do so. Also, one needs to know what the actual readership of the articles is like.

I am under the impression that the Daily Mail is written for and by people from working class environments and communicates ideas held by some people in this group, though certainly not all. The ideology of the educated classes is more so represented by papers like the Guardian, which is also written by people who come from ABC environments. (I should warrant that I am working on impressions, but I would be surprised if I were proven wrong.A research project to back up this hypothesis could take the form of a survey for journalists of the various papers, to ask about their and their parents' education, type of work and income and their political leanings.)

Now, if both groups actually read papers written by their own group, then where does the transfer of ideology happen?

Another source of material analysed in the book is the Cosmopolitan. Machin and Mayr show how its imagery and articles paint a streamlined, idealised and kind of vapid picture of what women's lives are or should be like, and then promote the accesoires that belong with such a lifestyle. It is very entertaining to read their minute analysis of the high-pitched lighting and absolute absence of any clue as to what type of work the stylishly dressed women are doing.

A question that they leave open, which is fair enough to them I suppose, is "who actually buys this crap?" Who are these women spending actual money to read the magazine? Who takes the barely obscured sales pitches and laughable advice serious? Now beside all the people who read the magazine for a laugh, although that may very well be a majority of the readership, I believe that the intended audience of the newspaper is a group of girls and women who do in fact have an image of what their own lives are or should be like that matches the image sketched in the Cosmopolitan. They buy the magazine because they would actually like some advice on what make-up products are available and how they could go about wooing a man, in the same way that I bought the How To Do Critical Discourse Analysis book because I wanted to know precisely that.

If this is true it means that the group who reads the magazine does so because they already share its ideology. The same may be true for the newspaper choice; the Daily Mail readership shares its fairly explicit racism, its sense of humour and its obsession with "crazy murder beasts" who batter little children. The Guardian readership would indeed like to be informed about the latest developments in the NSA debacle or what's on show in the country's modern art museums. That's why they buy the paper.


In conclusion, ideological hegemony via newspapers may not work in the way the authors seem to suggest - ideas "produced" by a powerful group that serve to prolong their domination over the less powerful group. In a democracy, this theory belittles the wit and agency of those supposedly subordinate groups. Rather, each group communicates their ideology to other members of the same group, who are not "led to believe" new discourses but who in fact already agree, which is the premise that their voluntary consummation of the information is based on. Within the groups discourses develop organically, but they will be slower to filter down from the one group to the other.

Rather than media, education may be a key to how some discourses are communicated across social boundaries. Again it should be asked who decides on the content, who communicates it to the children, and how much of it the children actually believe and internalise.

I'm collecting opinion articles on SA language policy

The unfounded fears of a Zulu hegemony by T.O. Molefe

Quote:

Mabuza’s comment underlines what has perhaps been the most surprising aspect of the reaction, which is that some of the backlash has, for various reasons, come from black South Africans against what is perceived as an act of Zulu domination.

I'm thinking articles like these would be useful for critical discourse analysis, though of course the first article I come across has to be one of which I share the outlook.

So is this one: KZN University: A Storm in a (Zulu) Teacup by Pierre de Vos (whose blog happens to be my home page), although I don't fully support his stance on Stellenbosch as an Afrikaans-medium university seeing as how Afrikaans is itself threatened by English dominance as well. It should make space for black students, probably through steering away from Afrikaans only, but it wouldn't be unfair to ask the students to take a class in Afrikaans along the side. Vice-versa the university can offer isiXhosa classes to the Afrikaans-speaking students. The ideal, I believe, would be to have a number of multilingual universities throughout the country, each of which has a main emphasis on the language that is dominant in the particular region but also offers courses in the second and third language of the region. I haven't yet figured out how to make this workable.

Link to a page on the actual language policy considerations of the University of Stellenbosch (in Afrikaans).


UL multilingualism

The new KwaZulu-Natal University policy is not unlike the policy of the University of Luxembourg, which I will be visiting next week for a conference. In their founding text (from 2003) it stipulates that multilingualism is one of the main founding principles:

 « le fonctionnement de l’université se fonde sur (…) le caractère multilingue de son enseignement ». Les langues de l’Université sont : le français, l’anglais et l’allemand.

Le multilinguisme est un point essentiel du développement stratégique de l’UL car il peut apporter l’atout unique d’un diplôme bilingue, ce qui est un créneau indéniable et abordable du fait du contexte multilingue dont bénéficie l’UL : Luxembourg pays aux trois frontières, au cœur de l’Europe, abritant de nombreuses institutions européennes. Le multilinguisme apparaît comme un élément incontournable, voire même central de la renommée internationale de l’UL.

What they're saying is that because of Luxembourg being geographically wedged in between France, Germany and Belgium and its central position in Europe (again, mostly geographical), multilingualism is "inescapable".

In fact, the UL goes much further. All courses are in fact taught in German, French and English and by the time you graduate, fluency in all three is expected. Moreover the staff need to be able to converse in Lëtzebuergesch as well in order to facilitate interaction with students.


Conversational languages

The difference is of course that there is a plethora of universities teaching in any of the UL's three languages already, whereas isiZulu and isiXhosa are more like Lëtzebuergesch: the native language of the majority of the population of the region where the university is situated, but seen as a language of conversation rather than writing, or god forbid, universitary teaching.(I'm not sure whether UKZN staff are required to be able to hold a conversation in isiZulu; I believe that that is in fact one of the purposes of their new policy.)

Stock photo

A small token of corporate language policy

The Swedish Språkråd (language board) have decided not to include the word "ogooglebar" (ungoogleable) in their list of new Swedish words due to a feud about it with Google. The Råd wanted to define it as "cannot be found through a search engine" but Google has apparently been hunting after usage of its name to signify search engines in general rather than Google in specific. They put their lawyers on the case to make the definition say "cannot be found through Google". The språkråd have expressed their disappoinment that Google tries to control the language in this way. 

Source: Onze taal magazine mei 2013 (free translation)

I thought this was interesting in line of the previous post on the way McDonalds and Apple control language use with regard to their products. I'm not entirely clear on why Google doesn't want its name to be used as a word for search engines in general though - surely it would be beneficial to them if people directly associate searching online with using Google. Opinions welcome.

Dissertation methodology

Picture by Frank Bohbot taken from ignant.de


I've started the work for the dissertation I'm going to be doing all year. I'm still in the blissful first stages: swimming around a bit and reading very broadly, all I can get my hands on. In the past two weeks I made good acquaintance with an introduction to sociolinguistics by Mesthrie et al. and now I have moved on to a stack of books on the methods and assumptions of critical discourse analysis (less fun to read, not as many cartoons).

The research question as of yet is: which linguistic analysis methods are useful in the study of language policy and planning?

This is different from what I had thought of initially. At first I wanted to research the impact of language policy and planning (LPP) on internal language change. This was my abstract:

Language planning and policy are a well-researched area of study, but the focus is strongly on the political side of things; how can we ascertain that people have the right to use their language for administrative purposes? In which language should education be provided in multilingual countries? The purely linguistic aspect of language policy has been given less attention. The question this dissertation will attempt to answer is what influence language policy has on internal change of the affected languages, thereby tying in to a bigger question of what factors trigger language change.  

In this dissertation I will first make a classification of types of language policies based on actual policy decisions with regards to language planning and regulation. For each type of policy I will investigate how this might affect internal language development and provide examples from languages affected by these policies. The conclusion will reflect on how these findings relate to the bigger debate on language change in general.

The feedback I got for my first proposal suggested that the chapter "Linguistic Analyses in Language Policies" by Ruth Wodak was a good start for such a dissertation. That chapter didn't mention my proposed idea at all though, but instead seemed to suggest that the only feasible method of linguistic analysis in LPP is critical analysis of texts proposing language policies. Hence I now feel that I ought to try this method also.

To criticise my own idea that you can evaluate language policies by analysing the way they impact on the languages they police; it goes against the principle of sign arbitrariness of De Saussure. The language is not better or worse at signifying meaning before or after a change, no matter whether that change be onset by a policy of some kind. However there are some social aspects - e.g. language attitudes and economic benefit - that do get better or worse as language policy changes.

Another assumption underlying my original proposal that I now don't agree with is that you can draw a clear line between linguistics and sociology or politics. There are more and less "social" approaches to studying language and LPP but they blur into each other and overlap very much. Moreover I implicitly made the assumption that this distinction is meaningful and important. It serves to delineate the number of topics that need to be discussed in a degree on any of the subject fields, but that does not mean that it is a good reflection of reality.

What I feel I have to do now is try out a set of different methods and approaches, preferably on and to the same case study. The choice will focus on the more "linguistic" type of investigation as that would be what I can get the most assistance with within the School of English. The purpose to my mind is to get an idea of the relative benefits and helpfulness of each of the methods and the type of information that can be acquired via them. I still want to look at language change and variation, but I also want to critically analyse texts surrounding my case study, and perhaps I can investigate language attitudes as well.

The book I've started reading at the minute is "Methods of Text and Discourse Analysis" by Titscher et al. I found it hard to read at first but then I employed the tried and trusted "line per paragraph" summarising strategy. Then I got into the flow and stopped summarising as it was a bit tedious, but by now (a few hours later) I have forgotten what the bit that I didn't take notes for said. The main point they have made so far is that all research methods are, implicitly or explicitly, related to particular theoretical assumptions. They then went on to set out a four-step research design decision procedure. The first step is to decide what the research is for; finding explanations, testing hypotheses or describing. The researcher then needs to decide how involved they have to be with the source of research data, how critical they want to be of predetermined categories, and whether they want to do a snapshot or track changes. More on this later.

iMc: Persuasion and word elements

Did anyone else notice that two of the most established brands, McDonalds and Apple, both use a recognizable element in their product names? Mc/Mac for the former i.e. McChicken, Big Mac, and a lowercase i for the latter i.e. iPhone. What I'm most impressed about is that they get people to actually call these products by the name they've given them; they're not having breakfast out, they're eating a McMuffin. You don't just have an MP3-player, you have an iPod. (I've even heard people call Samsung mp3-players "iPods" but those people were all old.)

Herstart

Het nieuwe semester is begonnen. Ik had gepland om allerlei vakken waar ik eigenlijk niet voor ingeschreven sta te auditeren en dat plichtmatig ingeroosterd, maar desondanks heb ik me gisteren achter de computer verschanst en hoegenaamd niets volbracht. Vandaag werd ik doodmoe wakker, te moe om lang genoeg rechtop te staan om me aan te kleden, zodat ik besloot om op een ander matras nog wat verder te slapen. Zo heb ik al drie lessen gemist. De scriptiebegeleider heeft (eindelijk) gemaild en laten weten mij volgende week te willen spreken, wat wil zeggen dat ik deze twee weken één officiëel ingeroosterd lesuur heb. Vandaag heb ik me in de regen gewaagd om wat boeken in te leveren - te laat volgens het systeem, omdat mijn betaling voor dit studiejaar nog niet is verwerkt geloof ik. Op de natte trappen en rondom de poorten van het hoofdgebouw zaten groepen nieuwe eerstejaars, duidelijk nog te bevangen door alle nieuwe ervaringen om te merken wat een grauwe dag het was. Ik interpreteerde hun drukke praten als nervositeit: de stiltes vullen in een eerste gesprek met potentiële nieuwe vrienden. In het gebouw waar ik de afgelopen maand gewerkt heb stond een lange rij buitenlandse studenten die de receptie wilden spreken, ordentelijk gehouden door een van mijn voorheen-collega's. Door mijn inactiviteit gisteren kon mijn a4-tje met gewerkte uren, dat ik toen had moeten inleveren, pas volgende maand verwerkt worden. In de bieb ben ik naar de kasten met taalkundeboeken gelopen, op de tweede verdieping, en heb min of meer lukraak interessant ogende boeken uit de kast getrokken. Taalkundeartikelen vind ik meestal makkelijk om te lezen, volgens mij omdat taalkunde nabij mijn normale modus van denken is, maar misschien is dat onzin - misschien zijn ze gemiddeld beter geschreven omdat men in die sector zelfgeselecteerd is op taalgevoel. Ik las een artikel over een praktisch onderzoek in Strassbourg - naar taalkeuze van klanten en verkopers in warenhuizen - en de intro van een artikel over de filosofie achter critical discourse analysis. Iets wat daarin werd gezegd maakte grote indruk, namelijk dat taal niet op zich beschouwd kan worden los van sociale status, maar dat het de sociale realiteit juist bouwt of helpt te bouwen. Daarna was ik echter te moe om door te lezen. Thuis stond ik een tijdje met mijn hoofd tegen de waslijn, maar toen vond John dat ik gek deed en maakte hij citroen-tijmchips en thee voor me.

Omdat ik volgend jaar wellicht in een Duitssprekend land verder wil studeren heb ik me samen met een vriendin ingeschreven voor een Duitse taalclub, waarvan deze avond de eerste les. Tot mijn geruststelling was het precies wat ik had gehoopt, namelijk een soort excuus om zoveel mogelijk Duits te spreken, met een lerares wiens functie niet was om ons oefeningen te laten doen of over grammatica te drammen, maar om met onderwerpen voor gesprekken te komen en desgevraagd een woord te vertalen. Op de vraag waarom ik daar was heb ik enigszins trots laten weten dat ik overwoog om in Luxemburg een Master te gaan doen. Gisteravond zag ik namelijk dat daar een drietalige studie over meertaligheid wordt aangeboden en het lijkt me een bijzonder goede optie. Claire hakkelde meer dan ik maar ik was erg blij dat ze zich ook had ingeschreven, het voelt een stuk minder dreigend tussen de andere deelnemers, die allemaal in "Ruhestand" waren - met pensioen dus. Na het eten heb ik een begin gemaakt in Frisch' Homo Faber, dat mama voor me mee heeft genomen. Het leest het beste met Google Translate ernaast om snel alle onbekende woorden op te kunnen zoeken, hoewel ik had verwacht dat de computer te afleidend zou zijn. Nu ben ik nog wakker met de bedoeling een post te schrijven over dat taalkunde niet aan zijn prescriptiviteit kan ontsnappen, maar het is meer een soort dagboekentree geworden. Wat dan ook.

It's done!

I've handed in the finished report last Friday. Didn't even have to stay up the night before, which is quite a personal achievement. I attribute it to keeping track of the work on here. Check out the conclusions!

Pictures (c) John Hill.

Interview questions

I spent the morning writing my interview questions. John helped to type it up. Look at the nice format:

       

I chose to use a lot of questions from Brady, Verba and Schlozman's article (the one I discussed here). I want to ask the interviewees about their resources and civic skills in order to identify obstacles to participation, and since the questions by Brady et al. (Herafter BVS) were designed to do exactly that it makes sense to copy them; and this way the results can be cross-compared.

There are two major complications with importing BVS' questions. First of all, I am interviewing people in a mental health service, but a lot of the questions are not entirely relevant to their day-to-day life. For instance the question "Last week, were you working full time for pay, working part time for pay, keeping house, going to school, or something else?" can already be answered to some extent for probably all of the interviewees: they visited the service where I will be talking to them. In order to fix dis disparity I have added a couple more specific questions and slightly changed others - to the question in the example I added the option "visited the service".

The other complication is that this survey was designed for people in the United States, but this is Northern Ireland. The problem is not just that I have to edit the questions so that they apply to the local situation, so for instance "secondary school" instead of "high school". More importantly, because of the political situation in Northern Ireland people may feel scrupulous or hesitant to answer certain questions such as: what language do you speak at home? Are you a UK citizen? What is your religious denomination? I don't want to ask such questions unless strictly necessary. I added a disclaimer to let the interviewee know the research is not about the sectarian division and they do not have to tell me what side they are on.

BVS designed their questions for a large-scale quantitative interview. I am going to interview too few people to meaningfully compare my results, but still their results could serve as a way of placing mine in context. For instance, if a participant turns out to have very little time, we can refer to BVS who found that people with little time generally do not participate as much. The ease of integration of their questions in my interviews shows that a question is not inherently qualitative or quantitative; it depends on the number of research participants and on how the acquired information is processed.

P.S. I updated my consent form so that it is relevant to the actual questions. Here

Suggested search gives an idea of people's image of mental illness.

Research (now with vulnerable adults)

My practical research (as opposed to the literature review) consists of two major parts, one of which I've already completed and the other I haven't made an appoitnment for yet. I'm going to have to hurry as I've a month left to get EVERYTHING done so interviewing, writing, editing, cleaning up the references, getting the whole thing printed and ring-bound somehow.


Research design

Part one is an experiment, to do with the All-Party Group I described in the previous section. For one of the meetings we invited a service user to come along to give a talk about her experiences with the particular piece of legislation that the meeting was about. After her talk I handed out surveys for present MLAs and MLA representatives to fill out, about what they thought of the talk and if they had had contact with service users before, that sort of thing. Beside the surveys the oral comments from those present, my own observation, and importantly the conversations I had with the person who gave the speech were very useful sources of information. Conclusions from the experiment relate to how a service user can be accommodated to give such a talk and how it can have the most impact on the decision-makers it is meant to influence. Here is the questionnaire I used.

Part two of the practical research, the part that I haven't done yet, would be interviews with service users, nurses and officials about their experiences with politics and the obstacles and barriers to their participation. The questions I had for this are actually, in hindsight, pretty bad; I'm basically just asking them what programme they think should be ran. That's alright as a side question but not as a main question I don't think. Having done the research that I've done now I think there should be:

1. Profiling questions about their type of illness and what class they would say they were in; middle, working, upper?
2. Identifying barriers or obstacles to participation
1. A considerable section on civic skills -- maybe I could ask some of Brady, Verba & Schlozman's original questions. This is to test my thesis that this is one of the main obstacles. Includes questions about education, work experience and confidence.
2. Questions about their opinions of MLAs and of Stormont to see if they think politics is really impenetrable, plus a couple of knowledge questions about Politics to see if they need informed about politics, as this is one of the Rethink Politics programme's main pivoting points (besides skill building.)
3. Searching solutions: would they participate in 
1. a programme to help them build civic skills 
2. a committee or board 
3. a user-run service... and which do they think would help (and why?) (and which programme do they think should be ran, if any)

Research ethics

As much as I like this whole blogging thing I won't be able to post any of the evidence or the results on here though. That's part university etiquette and part common decency, succinctly summarised as research ethics. When talking about research ethics, people suffering from mental illness are generally classed as vulnerable adults, along with people with Down's syndrome and learning disabilities. The main ethical priorities when doing research with this "group" are informed consent, privacy and confidentiality. I will now explain what these mean in general and for my research in particular, among other issues.

Informed consent means the participants in the research know what the research is about and what the risks and benefits for them could be. With people with learning disabilities the risk is that the researcher might make them sign a form to say they have read and understood the risks of the research, when in fact they have no idea what's going on. One time as a kid I was playing with marbles with a girl my age who had Down's syndrome. I asked did she want to play "keepsies", i.e. whoever won got to keep the marbles, and she said yes; but then when I won and wanted to keep her marbles, a classmate told me off. His argument was that whatever I'd ask her, she would probably say yes despite not understanding. Here we could say there was no informed consent despite her "signing my form". I don't think this scenario applies to mental health service users as much as it applies to people with Down's syndrome. In fact the whole point of my research is that mental health service users may have lost control over some parts of their lives, but this does not mean that they are unable to make sensible decisions about any part of their life. (What do the experts say?) My consent forms for the interviews: 1, 2

Another problem of informed consent is that in some researches it is crucial that the participant does not know exactly why they are being asked to do something, as it could influence the way that they do it. This is not a problem in my research; for the interviews I will tell the participants in advance what my research is about and why I'm asking certain questions, and for the experiment I went to great lengths to make sure that the speecher didn't mind me handing out questionnaires and I had her read the questionnaires and told her I could edit them if she wanted me to.

My main concern was that she'd feel like she was being judged for the speech - which would be understandable as the questionnaires are basically asking MLAs "what did you think of this speech". I think this demonstrates the tension between getting research results and taking care of your participants. If I'd made her feel too bad about herself to give the speech then I couldn't have gone on with the experiment despite how many positive implications it might have had for mental healthcare in general and for my own academic credentials. This is now drifiting away from informed consent in the direction of psychological harm, which is something that you want to avoid as a researcher. I think psychological harm is a bigger risk when doing research with mentally ill people than lack of informed consent is, as service users may already lack self-esteem. If they are portrayed negatively in the research report or if they get the idea they did something "wrong" e.g. they gave the wrong answer to a knowledge question, this might further undermine their self-esteem.

Mental health service users also have a lot to win or lose when it comes to forced treatment and imprisonment and rights to self-determination. This was also noted by Barnes et al. while they were trying to find user-run groups to participate in their research:

Users of services have objected to being subjected to the professional gaze of the researchers as they are also objecting to being constructed as passive recipients of welfare services. In some instances they have refused to participate in researach projects. ... Considerable discussion was required before one particular group finally agreed to be involved. ... Researchers working in this area have to develop new ways of working with users as participants rather than subjects of the research process. (p.10-13)

Privacy and confidentiality together consist of the considerations: what can I ask, what can I write about and what do I do with the data afterwards? It's a bit like with the NSA. People may not be comfortable with their data being published all over the world, especially if it could still be connected to them in specific, and especially if it concerns incriminating, embarassing or very personal information such as experiences with drug use, memories of having been bullied or how long a person has been out of work for. Data can be anonymised, but the more detailed and specific the research, the more risk there is that participants can be identified by their remarks anyway. If there is one case study or one small group of interviewees, like in my case study, the risk of identification is quite high. Likewise it is higher in a qualitative study where participants are quoted at length than in a quantitative study where they represent a dot in a scatter plot.

To an extent risk of identification via quotes is inevitable especially if the point of the research is to ask people for their specific experiences, but the researcher should use their own good judgment in what information to quote and what to leave out. Specific placenames shouldn't be mentioned and names can be changed or left out of the report. In my particular case, I will be asking people for their work experience, but I'll avoid talking about that in any recognisable way. Once again, Barnes et al. came across a similar problem in their research:

Interviewees in one group had found it uncomfortable to have their words reflected back to them in the case study report. They were concerned that other group members would be able to recognise who had said what, even though individuals had not been identified. (p.14)

After I finish the research I'm going to have to destroy the records and transcripts of the interviews. It's a form of good practice even if there is no realistic risk that someone would find them and hound the interviewee for its contents. Really there shouldn't be anything that I could possibly still need it for and if I would use it in another way than for the reports, that would be something that the interviewees did not give me explicit permission for.


In conclusion, the risk that mental health service users would not be able to actually consent to the research is not very big and there is no deception involved. Real risks to studies in this area are negative portrayal of participants, such as making them seem like passive recipients of mental healthcare; causing psychological damage with unwarranted remarks or interview questions, and putting identifiable details from the interviews in the final reports. For each of these risks there are few absolute solutions other than the researcher being aware of this, using their good judgment and taking advice from others, including the participants themselves.

Administrative Support for an All-Party Group

In order to introduce the section on charity responsibilities I will talk about the charity I did my internship for, and what the internship work consisted of. First I'll explain what an APG is and does, then what the benefits of running one are for MindWise and what my job there consisted of.

What are All-Party Groups?

An All-Party Group is an opportunity for parliamentarians to discuss issues outside of the common room. They can bridge party lines, make alliances, ensure they are better informed of issues for debate and make plans for what action needs to be taken on these issues and network with representatives of organisations working in the field. Topics range widely, from housing development to jazz appreciation. In Westminster there are country groups as well, to discuss international relations between the UK and for instance Brazil or Qatar.

The All-Party Group meets regularly; ambitious groups may decide to meet monthly but bi-monthly or quarterly meetings are also common, as parliamentarians don't have much time. Meetings are often themed to a particular aspect of the group's topic or to a piece of legislation that falls within their field, e.g. the disability rights group may have a meeting about stigma, or one specifically about a new measure against unemployment. During the meetings there will usually be a couple of speakers who are experts on the specific issue, and there will be opportunity for a (panel) discussion.

The All Party Groups are meant as groups for and by parliamentarians. In Northern Ireland, the group has to be chaired by an MLA and only MLAs can be members. However, MLAs hold the right to ask for external support and this is where charities come in. According to the rules for APGs in Stormont:

All-Party Groups can choose to be supported by outside individuals and organisations. At the discretion of each group, outside individuals and organisations may contribute to organising meetings. They may also attend and speak at meetings. They can advise and support All-Party Groups, including through the provision of permanent secretarial support. They can even provide financial support or other material benefits, provided this is properly registered.However, they cannot become members of an All-Party Group and therefore cannot vote at any meeting or on any issue. Nor can they offer any payment, reward or benefit of any kind in the expectation that the Group or any member of the group will advocate or initiate any cause or matter on their behalf. It is acceptable, however, to arrange and pay for visits for members of the group where the purpose of the visit is related to the subject matter of the group. In such circumstances, members would be required to register receipt of such a visit on the Register of Members’ Interests. (p.13)

Advantages of external secretarial support

If a charitable organisation gives administrative support this has benefits for the MLAs as well as for the organisation itself. As stated MLAs have little time and so it may be too much of a burden to run an APG on top of their other duties, but with external secretarial support this is possible. Organisations already have a professional knowledge of the topic and are therefore better able to choose themes and speakers; they have contacts with other organisations in the field and so the meetings will provide better networking opportunities than if they were organised by an MLA (who, after all, have to spread their attention.)

For the organisation in turn it provides a lot of advantages to be the one running the APGs (rather than another organisation in the field). It increases their visibility for decision-makers and other organisations alike, and they do get some influence on promoting their point of view by inviting speakers who agree. For instance, by running the APG on mental health, MindWise's social model of mental illness gets a good podium rather than the more medicalised view that the Royal College of Psychiatrists would have (N.B. there have been speakers from the RCPsych, but MindWise decides on the themes of the meetings and gets to see the outline of the talk before it is given.) That said, in order to maintain credibility as representatives of the whole mental health sector in Northern Ireland, MindWise does need to invite speakers from many different organisations - their allies as well as their competitors.

Running an APG is a considerable amount of work, though. The administrative tasks include:

• booking meeting spaces and catering
• inventorisation of relevant organisations and stakeholders, making address lists, sending invitations, making attendance lists
• coming up with good themes
• identifying and inviting potential speakers, meeting up with them to plan their talk
• gathering typed versions of all talks, presentation outlines and information leaflets, and sending them to all attendants well in advance along with the agenda
• writing minutes during the meeting and sending them to all attendants afterwards
• getting approval for any decisions made from the responsible MLA

Health-related all Party Groups

Interestingly, looking at the list of APGs in Stormont (which is available on the internet, here) 15 of the 35 total groups have something to do with healthcare (I'm including everything from congenital heart disease to learning disability and pro-lifers.) This shows that the groups are a popular method of lobbying in the health sector in Northern Ireland, for whatever reason. John says the biggest employment sector in Northern Ireland is healthcare as well and that might explain it. I tried to count the number of health-related APGs in Westminster but there are a bit too many to count quickly - of the first five letters (A-E) there are 154 groups of which 32 health-related. That is about one-fifth when in Stormont it was almost half of the groups.

Institutional arrangements: How?

In the previous post I found that the process of building participation has two sides: the service user side and the institution side. The user can build their skills and try to be active and involved. The institution or organisation that the users are to participate in needs to change its attitude to users, on the one hand, and take practical measures to allow participation to happen, on the other side. In the previous post I talked about the BMHRG report and their examples of practical measures; in this post I will continue on that lead and talk about two other sources and their examples of practical measures.


Source 1: Tait and Lester get into the theory of involvement

The article by Lynda Tait and Helen Lester (link, scroll on to p2 of the pdf)  is probably the most directly relevant I've found to date - it's called "Encouraging user involvement in mental health services". It gives policy context, a bit of theory, reasons why it's important, reasons why it's hard, good examples and finally recommendations for organisations.

In the theory section they cite a schema devised by Peck et al. in an interesting sounding article that is somehow not findable on the internet (if you look at the content list for that journal pages 440-452 are missing, the article is 441-451) so we'll just have to work with what they say about it. The schema was in turn put together from different models of involvement. One of these focuses on the different roles a service user might have with regard to involvement, ranging from least involved to most involved: they could be the recipient of communication (about decisions that have been made); they could be a subject of consultation e.g. via surveys and councils; and they could be the agent in control, like in a user-run group. Consultation is seen by the authors as better than nothing, but not yet good; it is not seen as meaningful participation as the user does not have decision making power. Interestingly a page later (171) they say the emphasis should be on "partnership, influence or control" for users. Partnership is not in the schema on p 170 and they do not define it clearly so I don't entirely understand what the difference between a place on a committee and "true" partnership is.


Source 2. Cole et al. and indicators of the right attitude

To go on about meaningful participation a bit more; from the sources I have read so far I have got a better understanding of when participation becomes meaningful. Just a place on a board or a committee won't cut it, there need to be extra measures in place to ensure that the service user is listened to, taken seriously, and given actual decision making power. A lot of this is about attitude and the way people treat each other, and as a result some of the recommendations I have found take the form of indicators of the right attitude, rather than of things that are good in and of themselves.

An example of such an indicator is the following recommendation given by Cole et al. that people at the top (managers, planners, policy makers, councillors) should have regular contact with service users. I don't directly see the practical benefits of this recommendation in and of itself - in practice it would take a lot of time to organise when the input of the users may not have direct relevance to what each of the staff persons is working on. However, if you see this as an indicator, it would show that service users have been effectively involved in all levels of decision making.

The book by Cole, McIntosh and Whittaker is called "We want our voices heard" and it reports the findings of a project in York to increase involvement of people with physical and learning disabilities. The findings are fairly transferable to mental health, which ties in to my theory that a big part of increasing involvement is about adhering to general standards of accountability and democracy, rather than trying to work around the mental illness of the service user (which is what stigma would have us believe this was about). It is for a large part due to the general hierarchical structure of healthcare and social organisations that even "normal" people would have difficulty trying to exert influence. Yet for mentally ill people and disabled people it is on the one hand more important to get involved, because the organisations tend to have a bigger impact on their lives (for mentally ill people, mental healthcare service runs their housing and their day activities and social trust decides whether they are still eligible for disability benefits and then gives or withholds those). On the other hand, it is harder to get involved, as because of stigma they tend to be taken less serious than people without a diagnosis, and because of the illness they may feel more inhibited and less confident.


All recommendations in a list

Below some of the recommendations given by Cole et al. taken from the list entitled "In a service with effective user involvement we would see at the strategic level:"

• Users should be in committees and sub-groups with appropriate support; 
• There should also be parallel user-only sub-groups with negotiating power and a clear process for joint working with staff/professional groups.
  (One of the benefits would be that service users may feel less inhibited when talking to other users; furthermore they can talk in more detail about what changes are desirable from the user point of view. It's a bit like a parliamentary special interest committee in that sense.)
• The budget for user involvement is seen as essential and non-negotiable; a part of mainstream funding and not just an 'add-on' offered when there is some spare money.
  (I think this one is more tied to physical/learning disability than to mental health, but it raises the question what the costs of involvement could be. I think for mental health the obvious costs are for advocacy services and support of an advisor or carer; also for covering travel expenses as suggested by the BMHRG. Tait & Lester say that a service should create paid posts for service users.)
• Users should be involved in monitoring and evaluation on an on-going basis
  (Perhaps this is the opportunity for the paid posts suggested above)
• User involvement should be written into contracts.

Tait and Lester write that meaningful user involvement is not a one-off project, but it should be deeply integrated in every level of planning in a service. That's all well and good, but where do you start? They give a couple of examples of positive practice:

•  User-led research projects. In the decision-making process, research projects are an important stage as they influence the agenda: what are priorities for changes and improvements? When given a chance to do their own research, users ask different questions and may get different answers from the other users when interviewing. In one of my next posts I will write about research ethics; increasingly, users are objecting to simply being the subject of the professional gaze.
• User involvement in staff selection and training. I came across this idea before in the research for the post on user groups. This idea works on multiple levels; it gives the person who is applying or training for a job a better idea of who they will be working with, and what the job will be like. For the user it is a chance to exert influence on an important aspect of their own life, certainly if the staff is someone they would be in contact with every day. That said, even for a higher managerial staff position, it would improve contact and communication between the top and bottom levels of the organisation if users were involved in the selection. 
• Inclusion in the workforce. Given that users are experts on their own illness (they have lived it so they know what it's like living with it) it is not too far of a stretch to say that they should get paid positions supporting other people who are going through the same. Furthermore they could get paid positions in education and training of staff (see point made above) and in planning and administration. (This short article is specifically about the success of peer support worker programmes)

Coming up next

The "two sides" idea that I propagated in the introduction to this post - participation can be worked on from the user's side and from the organisation's side - leaves out the role charities and services can have in encouraging and enabling increased participation. In the next post I'll talk about what position they could and should take. I also want to reflect on what is more conventionally seen as political participation, as I have been talking mostly about advocacy groups and healthcare organisations so far (though which good reason. Which one? Stay tuned.)

The BMHRG suggests some very practical measures

(Note: I added a new page to the blog to explain the project I am writing these posts for)

I read the May 2012 report by the Belfast Mental Health Rights Group (BMHRG). They consist of service users and their carers and of families who have been bereaved through suicide, and they have ran a campaign for the past few years to try and improve first line care for mentally ill people in the Accident and Emergency room (A&E), specifically by lowering the time that people have to wait (4 hours just isn't acceptable if you are in a crisis) and by ensuring that people get a written notice of a follow-up appointment. In the report they explain how they have tried to monitor the progress on this campaign and in why they found it hard to. I wonder if A&E is really the best place for first line help as they are kind of notorious for making people wait for ages but to be fair the alternatives aren't as known or as accessible.

First of all I was very excited to read the following in their report as it confirms that my work so far has been on the right track:

Dr Helen Potts is a renowned expert in this area and she has previously
assisted the Belfast Mental Health Rights Group’s campaign for meaningful
and effective participation, her work and ours shows that participation requires
two things:
1.      Arrangements put in place to ensure participation at different stages
2.      Capacity building to ensure people have the ability to meaningfully and
effectively participate

We have been talking, on here, about capacity building; that's civic skill right there. However the arrangements at different levels are something that I still need to understand better; I think what it comes down to is that both the service user and the institution that needs to be influenced need to change things in order for participation to happen. The service user, with support from services (user-run or not) builds his capacity and in turn the institutions need to change their attitude to see the value and importance of involving users and carers and they need to put certain measures and agreements in place to make sure participation is meaningful, i.e. it is not just tokenism but users and carers have feasible influence and decision making power.

BMHRG go on to explain which practical measures they asked the Health and Local Care Board to take in order to allow the group to monitor progress and to know what was going on in the meeting. It is surprising how common sense some of these measures are, it seems like they are just requesting that common meeting etiquette is actually lived up to. This is their checklist (p.23/24 of the report):

Before the meeting:

• We had the date, time, location and agenda two weeks in advance.
• We had the opportunity to place items on the agenda and have them considered in a timely manner.

During the meeting:

• The language used was jargon free.
• Any information which was presented was in writing so we can discuss it with the rest of the group.

In general:

• Any disagreements were resolved at the meeting effectively.
• Our expenses were covered.

The list shows the challenges for any group of volunteers to participate: people have jobs/activities of their own so they need to be able to plan the meetings in advance and agree who attends them; they need to be able to discuss the meeting outcomes together and so they need to have the agenda and all the information from the meeting. The covered expenses makes sense if you know that a lot of service users rely on disability/jobseeker's benefits, but it also highlights that their participation should be valued by the Board. The Baoards's goal, after all, is or should be to offer a good standard of care; a goal which they cannot reach without input from those on the receiving end of the care.

The group sent the Board evidence that in over a year, these standards had not at all been lived up to. The Board have since given a staff member the task to ensure that they will in the future be lived up to; they have further said that they will use the lessons learned here in their wider participation projects, and that they would like to set up meetings so that this can be done. (p. 26)


Conclusions:

• The responsibility for making participation happen is on the side of the institutions as much as it is on the side of the service users
• Some of the measures that the institutions can take to ease participation are very practical in nature 

As for the attitude change; Liz Sayce and Barnes et al. (see previous post) all hinted that a lot of attitude change can be achieved by "just doing"; if a person who is open about their diagnosis finds a job, eventually people will realise that they can function normally and that they are not a constant threat (Sayce). For user groups the same goes: if a group calmly asserts themself and shows that they are well-organised and reliable, institutions will eventually come to accept this. In the case of the group studied by Barnes et al., the attitude change had been so far-reaching that by now, officials in the field feel it would be unacceptable for them to make a decision about local mental health planning without consulting the group first.

User groups

Tuesday I ended my post with Mary Kirlin's suggestion that involvement and self-organising is the best way to build civic skills. Today I would like to continue on this lead by talking about self-organisation of mentally ill people, or user groups. The question that would be interesting for MindWise is how they can (and whether they should) encourage and support similar initiatives within their organisation.

During my research before December '12 I already came across a couple of sources on user groups and self-organisation. I will discuss the sources here one by one.


Social versus biological perspective 

The first source I will discuss here is a chapter written by Julie Chamberlin simply called "User-run Services". It is published in Models of Madness edited by Read, Bentall and Mosher, which is a book advocating a less medicalised way of "dealing" with mental illness. They promote the idea that  "people are driven crazy by bad things happening to them" rather than by "genetic predisposition or biological disturbance". Because of this change of perspective other solutions seem obvious. In the case of genetic/biological disturbances the problem seems less resolvable, and medication seems like the answer. In the case of someone just having had a really bad time and responding dramatically, the right reaction seems to lend the person a shoulder to lean on and have a good chat with them. Medication can still be used but only if the person wants it, and rather in a supportive role (e.g. flatten out extreme emotional lows and highs with medication but also take therapy) than as the main method of treatment.

As far as I understand MindWise takes a similar view of mental illness and they are big on the so-called Recovery programme. This entails that a person, supported by a therapist, sets their own goals and challenges which they need to face with the eventual goal of living as independently as possible, i.e. finding a job and living in private accommodation rather than mental health housing. That means that the service user defines their own needs and problems rather than having that done for them by professionals. This stance is elemental to make my research question viable in the first place, as the question of getting mentally ill people involved in politics is based on the assumption that they are citizens like all of us who can stand up for their own needs. As I'm not a psychiatrist, but a Politics student, it seems important to me to make it clear whose lead I am following and what I am basing my ideas about mental health on.


Chamberlin explains the ideas of user-run services

The debate about biological versus medical perspectives on mental distress is relevant here because Chamberlin notes that user-run services often start as a protest movement against the traditional mental health institutions. She says that they are not necessarily anti-psychiatry, but that even those users who support traditional psychiatry still think that service users are often treated with a lack of respect (p. 284). They criticise the strong division between professionals and users: the doctors and nurses decide what is good for the user and the user is simply on the receiving end of care: maintenance and medication. User-run services at the other hand emphasise on democracy and peer support.

She gives an example how one service started (in 1971): in a psychiatric hospital users were treated during the day and permitted to go home at night and in the weekends. Users were prohibited from contacting each other outside the hospital. However they found that "crises frequently arose precisely during the times when staff were unavailable (evenings and weekends). ... One Monday morning the patients arrived on ward and learned that over the weekend one of their number had committed suicide. Many strong emotions were expressed, and one immediate result was the clandestine circulation of a patients' phone list." People found the network more useful than the therapy and after they were discharged they tried to find more people who had similar feelings about psychiatric treatment and to discuss what they could do about it.


Sayce and activities of user groups

I also read a chapter from Liz Sayce's book From Psychiatric Patient to Citizen: Overcoming Discrimination and Social Exclusion. Chapter 12, "Making Inclusion Happen at the Grassroots", starts with a section about user-run services, which for her is a prime example of anti-discrimination work as the groups she has seen try to show the community that mental patients are also people, that they are able to organise themselves effectively and that they mean well. From the examples of the activities of such groups that Sayce and Chamberlin give it seems that groups like these are primarily for peer support and advocacy (an advocate is someone who can speak for the mentally ill person, accompany them to meetings to make sure their opinions and needs are voiced). The groups are in a good position for political participation as well as anti-discrimination work though, and indeed they are often active on these fronts.

This is the list I made of activities of groups mentioned by Chamberlin and Sayce:

• Phone network (C, see above)
• One on one support, talking and helping (C)
• Providing housing (C) (this is also a source of funding)
• Providing food for those who need it through contacts with shops (S)
• Providing a safe place from violence (S)
• Advocacy (C/S)
• Helping out in the community e.g. shoveling snow (S)
• Providing one another with information on their rights (C)
• Helping those who are looking for work, e.g. allowing them to use the office voicemail as a return telephone number. (S)
• Activism (S, C quoted by S, not expanded upon)

Power through soft persuasion: Barnes et al.

The third source I would like to discuss is Unequal Partners: User Groups and Community Care by Marian Barnes, Stephen Harrison, Maggie Mort and Polly Shardlow. They did a case study about user groups for mental health and for disabled people. The study is focused on how such groups try to influence care and policy and how they are perceived by political and management figures.

The mental health group they studied in detail was mainly an advocacy platform, but aside from advocating for individual users they also had contacts and joint partnerships with health and social services; they invite officials to attend their own meetings and vice versa they suggest that the health and social services make posts for service users on their boards. The group is not very radical in their approach - they value soft persuasion through communication, they do not "come in banging the drum". However, they have created a platform to ensure user's views are not ignored, and they are taken seriously in doing so.

Barnes et al. note how since the foundation of this group in the mid-1980s, the attitude to them has changed considerably. Involving the users in the group in the decision making process has become the norm. The officials interviewed for the study (psychiatrists; managers and directors in the field) confirmed that they saw an important role for the group in challenging mental health professionals, challenging mental health management, providing information and education about mental health, ensuring participation of service users in decision making processes, and advocating for service users, e.g. in patient case reviews.

Campaigning was "not seen as a deliberate strategy" by the group, but it had been done; in reaction to plans for service developments in their area one of the local sub-groups had started a campaign which had included writing letters to MPs. However the group members feared that if they adopted a "deliberate campaigning stance, this could be experienced as threatening by officials". This shows again that they have opted for persuasion through communication, as they found it worked better and they were taken more serious than if they would be more rebellious and activist.


In conclusion/summary

Although user groups are often set up by people who find that the traditional system has failed them or does not sufficiently meet their needs, this disappointment with the system does not mean that their main activity consists of rallying against it. Rather, groups often function as a network to supplement traditional mental healthcare with peer emotional support and advocacy.

However their being set up by users, for users (often with long histories of mental health care experience) lends them legitimacy and authority, meaning that they are in a good position for anti-discrimination work and participation in (political) decision making processes.

This political activity can take the form of campaigning and activism: organising protests, drawing banners and writing letters to MPs; but it can also mean that the group posits itself as a talking platform for users and encourages services to consult them before making decisions. The latter one may even be more effective as officials tend to cooperate more when they do not feel threatened; however it also means making more compromises.

To relate this back to civic skill - it is undoubtedly being built by individuals who decide to organise a user group, however the sources I've found so far mostly highlight the other, more obvious benefits of user-run groups, also with regard to political participation.

If you are interested in this topic, try this report about research across a large number of user groups.

Building civic skill

In Friday's post on political exclusion I finished with a note about civic skills, a concept developed by Sidney Verba, Henry E. Brady and Kay Lehman Schlozman. I would like to expand a bit more on that concept in this post as it seems to me like this concept could be very useful in designing recommendations for encouraging participation in certain groups; they could receive training which focuses on building civic skills. Moreover I think that besides civic skill, confidence is an important factor in encouraging someone to participate.


1. What is civic skill and how do VBS measure it?

Civic skill is introduced in the article Beyond SES: A Resource Model of Political Participation, as one of the resources that people need to have in order to participate in politics. It is defined as "the communications and organizational skills that facilitate effective participation"(p. 271). Civic skills are developed through work experience, but also through being part of organisations (e.g. through volunteering for Humanitas), in high school government, and in one's church.

In their research the authors have used multiple indicators for civic skill, and they argue that these are perhaps not perfect but nevertheless do the job of indicating. They ask questions about:

• Level of education
• Participation in high school government (this one surprised me a little)
• Language proficiency
• Self-described skills and confidence
• "Skill acts"; how often did a participant attend a meeting where decisions are made, plan such a meeting, write a letter, or make a speech or presentation in the past six months a) at work b) for an organisation c) for a religious organisation (e.g. church).

2. Predictions about civic skills of mentally ill people based on known statistics of their employment, education etc

My hypothesis is that for mentally ill people, level of education and language proficiency will be roughly the same as for the rest of the population or slightly lower, but the real problem will be with the skill acts and the confidence. Note that these are related to each other: if a person writes a lot of letters he is more likely to feel confident in doing so (and vice versa.)

In this book I have here The Fundamental Facts 2007 from the Mental Health Foundation, they simply say that "low levels of education... are associated with a greater risk of experiencing a mental health problem" (p37). However, looking at the source they quote, I do not think this conclusion is merited. This (it links straight to the pdf) is the source they quote, a 2002 report by Her Majesty's Stationery Office. Table 2.1 on page 10 is about education level v. type of disorder. Looking at the column with all disorders grouped together and the one with respondents with no disorders, the differences can hardly be called significant: 28% of the people with disorders have no qualifications  versus 27% of the people without. 10% of both groups left school at 17. 39% of people with a psychotic disorder left school at 15, but then, there were only 60 such respondents.

This article however, "Education, sense of mastery, and mental health" is based on the premise that low education and mental health problems are linked - so there must be some truth to the claim. They refer to this source. I am now suitably convinced as they're psychiatrists and I'm not. The former article mentions that poor mental health may be one of the reasons why people have trouble completing their education. They advocate increased support and guidance for those who have educational problems.

It is a known fact that mentally ill people have more difficulty than average in getting and keeping a job. Sources: National Health Development Unit report, British Psychological Society (I am laughing at the line that they found "being a woman is the other strongest trigger influence on subjects with a genetic predisposition to mental disorder."). Also, an article from the American Psychological Association to say that unemployment also causes mental health problems. Relevant for our current topic is that if people are unemployed, they will have fewer opportunities for those skill acts that Brady, Verba and Schlozman talk about.

I do not have any statistics on organisation/church activity of mentally ill people, nor on their self-described skills (although I think that mental health problems often go hand in hand with low confidence and self-esteem, maybe because of the unemployment, the stigma attached to mental illness and the feeling of lack of control over one's own life.) I think it would be worth asking these sorts of questions if I get a chance to interview more people though; that said, anyone I'm going to be able to reach will already be a fairly active member of MindWise or NIAMH.


3. What would civic skills training look like? With help from M. Kirlin

For now I am interested in the question what sort of training could be offered to mentally ill people in order to help them improve their civic skill.  Let me advocate this a bit more: that civic skill is picked up largely on the work floor means it is also a job skill. Phoning people, writing letters, organising and participating in meanings; not far from the typical office job. Such training would need to be set up in such a way that it helps to build the self-confidence of the participants rather than patronise them (for instance with overly easy exercises). All in all it would work on several fronts at once; encouraging people to participate in politics and make their voice heard, preparing them for a job and helping to build their confidence at the same time.

For ideas on how to build civic skill I will borrow some ideas from Mary Kirlin, who in turn also got the idea from Schlozman, Verba and Brady's research. Her research focuses on adolescent "civic socialization" which I will remember as a key term that may become important later. By trying to apply her research to mentally ill people I am not trying to suggest that they are like adolescents, but rather that there is reason to expect that skill training that works in one place may also have positive effects for another group.

In this article she writes about community service programs and their influence on development of civic skills. She says she focuses on "how adolescents learn the doing of democracy, that is, active participation, not simply cognitive knowledge of political systems" (p.571). (Although seemingly straightforward, the distinction is a good warning for someone setting up a training programme). 


I think the most important conclusion in the article is that civic skill development happens when students are encouraged to organise themselves, to find out how to influence people and how to make collective decisions. This is why participation in high school government is almost unanimously found to be a good predictor of later political participation (she even claims with some conviction that this is not just due to self-selection of students who were already interested in politics), while sport clubs are negatively associated with later participation. Kirlin explains the latter:

While providing other benefits, organized sports provide little opportunity for civic skill development: the goal (winning) is predetermined, and adults undertake the planning for the season, organize the matches, and do most of the coaching. Opportunities for students to organise themselves, decide on objectives, and collectively make decisions are limited. The same may be increasingly true for service learning and community service: adults may have organized students too well, taking all the fun (and civic skill learning) out of the effort.  (p.573)

The point she makes here reminds me of something I read last November or so about mental health service users who organised themselves; initially they set up an emergency phone network for when staff wouldn't be available to call, so they could support one another; then that led to more and by now they have a walk-in service. I will try to find the source again tomorrow.

For now I would like to end today's post with a really cool thing from Kirlins's article - wish my university would offer this. In true Kirlin spirit I may go and suggest it to them.

I have begun testing this approach in an introductory undergraduate public affairs course. At the beginning of the term, students identify a public issue they would like to influence (by reading the local newspaper) and work in small (self-selected) groups to identify background, stakeholders, decision makers, and important timelines for the issues they have chosen. They then actively work to influence the outcome by writing letters, meeting with officials, attending and speaking at public meetings, and generating interest from others through media and other means. (...) Students have anecdotally reported increased understanding of the newspaper and local events, a much clearer understanding of who makes decisions and how to access them, and most importantly, confidence that they could get involved in an issue that interests them. (p. 574, my emphasis)

The importance of including everyone

It seems blindingly obvious to me that mentally ill people should be allowed to vote and participate in politics, which makes it quite hard to write about as the risk of stating the obvious is quite big. To keep it simple, let's first look at what international law and recommendations say. The FRA report on voting rights for people with disabilities or mental illness tries to answer that same question. They find that although international law legally protects the right to vote, they make an exception for mental incapacity which is seen as a reasonable ground to deny people the right to vote. However, between 2004 and 2006 a bit of a turnaround has happened in the attitude to mentally ill people's rights. I found some statistics here that show that Scottish awareness and stigma tackling campaigns helped to improve people's attitude to people with mental health problems. 2006 is also when the UN Convention on the Rights of Persons with Disabilities (CRPD) took place, and FRA quotes a number of Recommendations of the Committee of Ministers to Member States concerning this topic. One of the recommendations, Rec(2006)5 of 5 April 2006 I like especially because it's straightforward in stating the democratic principle this is about (even if it talks about people with disabilities rather than specifically with mental health problems):

"The participation of all citizens in political and public life and the democratic process is essential for the development of democratic societies. Society needs to reflect the diversity of its citizens and benefit from their varied experience and knowledge. It is therefore important that people with disabilities can exercise their rights to vote and to participate in such activities."

In one of the next posts I will try to explain the concepts of legal and mental capacity, which are important to understanding how rights, control over one's life, and making decisions work legally for mentally ill or mentally handicapped people. Based on a judging that a person is legally incapable people could automatically lose the right to vote. Although in some cases a person may genuinely be unable to vote - a person who is severely mentally handicapped, for instance - to have the right to vote taken away automatically for all people who are considered unable to make wise decisions about their own life, even if only in some areas, is a dramatic measure. This is demonstrated by a case that came before the European Court of Human Rights, Alajos Kiss v. Hungary, also mentioned in the FRA report. He was placed under partial guardianship because of his manic depression and subsequently lost his right to vote, as stipulated in article 70(5) of the Hungarian constitution. The European Court found this to be improportional and argued that such restrictions should be applied very carefully, especially if applied to a "particularly vulnerable group in society, who have suffered considerable discrimination in the past".

The story of the "considerable discrimination" that the Court refers to is a sad and frustrating one of involuntary electroshocks, bullying, and locking people into institutions which only serve to worsen their conditions. You may well have seen One Flew over the Cuckoo's Nest - here's a review about whether that film is realistic in its depiction of mental hospitals. The film depicts some rather extreme examples of patient abuse, as may be expected from a film - how else are they going to get viewers? Nevertheless, as the author of the review notes, the film was helpful in bringing attention to unethical patient treatment.

The previous maltreatment of mentally ill people is a testament to what can happen if people are excluded from decisions that concern themselves. A more modern example is the Work Capability Assessment, which I helped to organise a debate about during my internship for MindWise. See report; the authors explain that the decisions made regarding the WCA are intransparent and not evidence-based. Luckily in this case people are clearly voicing their opinions; whether they are listened to is a next question.


Besides these political and moral arguments for why mentally ill people's rights to vote and participate should be honoured, participation also has psychological benefits. It makes sense; having control over your own life and noticing that other people take you serious is crucial to building self-confidence which in turn makes you feel happier. This is discussed in detail in an article by Lynn M. Sanders, "The Psychological Benefits of Political Participation."


It is not just for the benefit of mentally ill people, but also for democracy itself that inclusion is crucial. If mentally ill people are automatically excluded from politics, a corrupt politician could simply get their political opponents sectioned (he doesn't agree with me so he must be crazy!!) For an amusing, not entirely fictional example read The Unlikely Genius of Dr Cuthbert Kambazuma (Set in Zimbabwe). The same goes with not allowing prisoners the right to vote (Northern Irish political terrorist prisoners being a controversial example).

Holiday photos

Okay so I meant to post one of these mental health blogs every day but of course it takes some effort to get back into the swing, you know, after seven weeks of not having to do stuff. Here's a picture of the nice skies in Ruinerwold:

and one John took of me looking for seals

From social to political exclusion

This is the second post in a series about political involvement for mentally ill people. In the previous post I wrote about social exclusion and mental health, this time I want to explain what political exclusion is and what forms it takes.


Political exclusion is an aspect of social exclusion. In the previous post I quoted the wikipedia definition that social exclusion refers to "processes in which individuals or entire communities of people are systematically blocked from rights, opportunities and resources that are normally available to members of society and which are key to social integration." Political exclusion then consists of processes which have the effect that specific groups or people are not or not fully involved in the democratic decision making process; they can or do not make their voice heard or are not listened to. (Note the difference between they can not and they do not make their voice heard, which ties into different ideas about the role of the government: should they involve people just passively or also actively? Is it enough to just give people the right to vote or does the government also have a duty to reach out to those who are not inclined to vote despite having the right to?)

First we should ask what rights, opportunities and resources are normally available to members of society. Political inclusion, involvement, engagement, happens through a number of channels, importantly voting and joining political parties but also charity work, lobbying, and participating in protest marches. Forms of behaviour that have a political effect but that I do not include are buying and selling, which has an influence on the market and which does suggest certain morals and ideas, and talking to friends about politics, thus influencing their ideas. Both of these activities have an effect on politics but very indirectly so; it would be hard to measure. At least for now I am looking only at activities in which people explicitly express their ideas and try to influence governmental politics directly. 


The resource model of political participation
Before I look at political exclusion further, it is important to first understand what normal participatory behaviour is like. I want to know a bit more, then, about how political participation is generally categorised and understood, so I found this article by Henry E. Brady, Sidney Verba and Kay Lehman Schlozman. It details the "resource model" of political participation that they developed to explain why socioeconomic status can predict the amount of participation of an individual quite well. In short, if you have more time, money and organizational skill you can give more of it. This is a reaction to what they call the SES model, which focuses on "components of socioeconomic status: education, income and occupation".

The main reason why their model is very relevant to our current pursuit is that it offers quite precise and well-defined measuring tools; how much income does a person get, how many hours are they in work or day activities (e.g. sport club). The question of whether mental health service users have the right resources available can then be answered, making it easier to distinguish between whether they can not or do not make their voices heard. It would point in the direction of the causes of political exclusion and in doing so the solutions will also become clearer.

Another important thing they note is that different resources can be handy for different types of political activity. This might be useful later on in the research when looking at the question of whether some types of political participation might be especially accessible for mentally ill people.

I have another report here by the Electoral Commission, called "Social exclusion and political engagement", which takes the same stance that "inadequate 'resources' (material wealth, education, and skills and membership of organised groups) constrain or promote [?] participation" (p.7). This shows that Brady, Venda and Schlozman's idea is not unique - maybe for the better, more support is probably not a bad thing. I'm still happy to have found the article as they explain it all very well and try to keep things measurable.


Election exclusion
Knowing a bit more about political participation, we can now look at practical forms of political exclusion. I'll talk about voting first. I don't think I have enough time/resources yet to discuss other types of involvement today in any way beyond pure guesswork (OK I'll posit one hypothesis, see below), but I'll come back to it later.

Voting is the most clear-cut and measurable example of political participation, and therefore also one of the most studied ones. First of all, looking at the law, we find that mental health service users are excluded from the right to vote in many European countries. We can also look at voting statistics to see whether those who have the right to vote, actually do (although this is a bit harder to find out.)

The European Union Agency for Fundamental Rights (FRA) has written a report entitled "The right to political participation of persons with mental health problems and persons with intellectual disabilities". They look mainly at the right to vote and to be voted for. The report was written "in the spirit" of the UN Convention on the Rights of Persons with Disabilities (CRPD) and notes that political participation "exemplifies the three key principles of the disability strategy grounded in the CRPD, namely: non-discrimination, equality and active inclusion." (p.7) (I'm making a note of this because I was happy to find it refers to what I said above about passive vs active inclusion.)

The report shows that the international community is quite divided on whether people who cannot take care of or responsibility for themselves should have the right to vote (also, whether prisoners or convicts should have that right.) In tomorrow's blog post I will discuss arguments for why people with mental illness should be included; for now it is enough to show that they are not. In 16 of the 27 EU countries considered in this report (written in 2010, so Croatia is not yet included) people are denied the right to vote or be voted for if they are under protective measures i.e. guardianship, regardless of their individual level of functional ability. Five countries (including NL!!! go us) have the right to full participation entrenched in their constitution and there are others that make specific provisions. On the UK (not-havers of a constitution) the report notes the following: "The Electoral Administration Act 2006 abolished the common law rule that a person lacks legal capacity to vote by reason of mental health problems." That said, it is slightly shocking how recently that ruling was still current.

On actual voting I have some sources that show that turnout is worse in socially deprived groups and communities. The Electoral Commission report I mentioned above notes that turnout among unemployed people is only 48%, but doesn't compare it to other groups, which is pretty terrible; luckily this website has the stats on the general turnout in 2001, namely 59.1%. It mentions research by Ipsos MORI which "estimates that 68% of social AB groups voted compared with 53% of DEs" (what are AB and DE groups, click here). These are both related to employment status, they also say the proportion of lone parents in a constituency was proportionally related to the turnout there. Although I haven't found any statistics on actual turnout among mental health service users yet, as I tried to explain in my previous post mental illness and social deprivation are very much related to each other, so based on the Electoral Commission data we can at least predict that turnout will be substantially lower.


Hypothesis to end the day's post
Following the line from the Brady, Venda and Lehman-Schlozman article, civic skill is crucial in organizing non-electoral forms of participation. That may contain the key to why it is harder for mentally ill people to get involved, as mental illness can inhibit civic skill; not to say that people haven't been properly educated or involved in their youth because often they have. The observable and obvious though is that mentally ill people have trouble taking responsibility and getting/keeping their life on track. Organisational and communication skills are exactly what one loses when mental illness hits and this is why such activities as charity work and organising protests are harder to get into.

Another post tomorrow, see you all then and thanks for listening.

Click here to see the sources found and used in making this post.