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Experiences of care continuity and recovery for people at the interface of primary and secondary mental health care in Wales: a thematic discourse analytic approach / NICHOLAS WEAVER

Swansea University Author: NICHOLAS WEAVER

DOI (Published version): 10.23889/Suthesis.53686

Abstract

This study explores talk about experiences of care continuity and recovery for people with serious mental health issues at the interface of primary and secondary mental healthcare in Wales. The approach adopted was qualitative, employing a methodology of thematic discourse analysis of talk generated...

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Published: 2019
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
Supervisor: Coffrey, Michael
URI: https://cronfa.swan.ac.uk/Record/cronfa53686
first_indexed 2020-02-28T19:42:37Z
last_indexed 2025-03-27T06:39:58Z
id cronfa53686
recordtype RisThesis
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spelling 2025-03-26T12:49:45.9936169 v2 53686 2020-02-28 Experiences of care continuity and recovery for people at the interface of primary and secondary mental health care in Wales: a thematic discourse analytic approach ca42cc01f4166dc6e55cc577aee25c5b NICHOLAS WEAVER NICHOLAS WEAVER true false 2020-02-28 This study explores talk about experiences of care continuity and recovery for people with serious mental health issues at the interface of primary and secondary mental healthcare in Wales. The approach adopted was qualitative, employing a methodology of thematic discourse analysis of talk generated by in-depth, semi-structured interviews. The study was conducted in two phases, the first round involving (n = 16) service users who had transited from secondary to primary care, and the second round involving (n = 16) workers and practitioners involved in supporting service users at the primary-secondary interface. The main findings were first that participants’ expectations were misaligned with transforming service structures and interfaces. Second, participants constructed competing versions of recovery in their talk. Third, analysis of talk revealed experiences of care discontinuities in multiple areas, concentrated particularly at the primary level. On this basis, it is argued that a proliferation of competing recovery versions, and misaligned expectations of transforming services, are closely allied with escalating service system complexity and fragmentation, with detrimental implications for care continuity and coordination. The role of neoliberalist, policy-based recovery versions such as the Mental Health (Wales) Measure 2010, is highlighted in colonising the recovery concept. The social theory of system versus lifeworld is used to provide a theoretical context for understanding recovery colonisation, potential distortion of the concept, and how this may be an additional factor for systemic complexity and fragmentation. In order to contain escalating service complexity, a balance needs to be struck between top-down, colonised implementations of recovery and bottom-up recovery versions rooted in the individual lived experience of the service user. The notion of the public sphere is also employed as a basis for study implications, to articulate a context for ideal speech situations where there is free function of communicative action at the intersubjective level of the lifeworld. Peer support groups, recovery colleges and online forums may serve as instances of a public sphere within which fruitful opportunities for education and construction of recovery approaches may be reclaimed. User / survivor activism may also have a role in securing this vital context for recovery construction. E-Thesis mental health, nursing, psychiatry, care continuity, recovery, discourse theory, complex systems theory, system versus lifeworld, colonisation of the lifeworld, floating signifier, Habermas 24 12 2019 2019-12-24 10.23889/Suthesis.53686 COLLEGE NANME COLLEGE CODE Swansea University Coffrey, Michael Doctoral Ph.D RCBC Not Required 2025-03-26T12:49:45.9936169 2020-02-28T15:14:49.3091115 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing NICHOLAS WEAVER 1 53686__17679__afb44e1c98934298bf33f54527870b0b.pdf Thesis_Nicholas_Weaver_2020_FV_Comp.pdf 2020-07-08T14:17:56.8905380 Output 2735948 application/pdf E-Thesis – open access true true eng
title Experiences of care continuity and recovery for people at the interface of primary and secondary mental health care in Wales: a thematic discourse analytic approach
spellingShingle Experiences of care continuity and recovery for people at the interface of primary and secondary mental health care in Wales: a thematic discourse analytic approach
NICHOLAS WEAVER
title_short Experiences of care continuity and recovery for people at the interface of primary and secondary mental health care in Wales: a thematic discourse analytic approach
title_full Experiences of care continuity and recovery for people at the interface of primary and secondary mental health care in Wales: a thematic discourse analytic approach
title_fullStr Experiences of care continuity and recovery for people at the interface of primary and secondary mental health care in Wales: a thematic discourse analytic approach
title_full_unstemmed Experiences of care continuity and recovery for people at the interface of primary and secondary mental health care in Wales: a thematic discourse analytic approach
title_sort Experiences of care continuity and recovery for people at the interface of primary and secondary mental health care in Wales: a thematic discourse analytic approach
author_id_str_mv ca42cc01f4166dc6e55cc577aee25c5b
author_id_fullname_str_mv ca42cc01f4166dc6e55cc577aee25c5b_***_NICHOLAS WEAVER
author NICHOLAS WEAVER
author2 NICHOLAS WEAVER
format E-Thesis
publishDate 2019
institution Swansea University
doi_str_mv 10.23889/Suthesis.53686
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
document_store_str 1
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description This study explores talk about experiences of care continuity and recovery for people with serious mental health issues at the interface of primary and secondary mental healthcare in Wales. The approach adopted was qualitative, employing a methodology of thematic discourse analysis of talk generated by in-depth, semi-structured interviews. The study was conducted in two phases, the first round involving (n = 16) service users who had transited from secondary to primary care, and the second round involving (n = 16) workers and practitioners involved in supporting service users at the primary-secondary interface. The main findings were first that participants’ expectations were misaligned with transforming service structures and interfaces. Second, participants constructed competing versions of recovery in their talk. Third, analysis of talk revealed experiences of care discontinuities in multiple areas, concentrated particularly at the primary level. On this basis, it is argued that a proliferation of competing recovery versions, and misaligned expectations of transforming services, are closely allied with escalating service system complexity and fragmentation, with detrimental implications for care continuity and coordination. The role of neoliberalist, policy-based recovery versions such as the Mental Health (Wales) Measure 2010, is highlighted in colonising the recovery concept. The social theory of system versus lifeworld is used to provide a theoretical context for understanding recovery colonisation, potential distortion of the concept, and how this may be an additional factor for systemic complexity and fragmentation. In order to contain escalating service complexity, a balance needs to be struck between top-down, colonised implementations of recovery and bottom-up recovery versions rooted in the individual lived experience of the service user. The notion of the public sphere is also employed as a basis for study implications, to articulate a context for ideal speech situations where there is free function of communicative action at the intersubjective level of the lifeworld. Peer support groups, recovery colleges and online forums may serve as instances of a public sphere within which fruitful opportunities for education and construction of recovery approaches may be reclaimed. User / survivor activism may also have a role in securing this vital context for recovery construction.
published_date 2019-12-24T04:46:42Z
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score 11.444473

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