Mad knowledge(s), difficult knowledge(s): Critical reflections on paradoxes

Mad knowledge(s), difficult knowledge(s): Critical reflections on paradoxes and unsettling relations in the politics of co-production in University-based mental health research Dina Poursanidou, University of Manchester, UK Tim Rawcliffe, NW Coast NIHR Clinical Research Network, UK Service User Academia Symposium Wellington, NZ 2 December 2014 My purpose in this paper Who we are ; Tims self-description Seeking to trouble the notion of coproduction in mental health research in Higher Education contexts by asking some hard questions

Look at key analytical concepts that have helped us interrogate the politics of coproduction in University-based mental health research A definition Co-production together with Public and Patient/Service User Involvement the focus of increased attention within policy, practice, education and research in the field of mental health care in the UK in the last decade In mental health research, co-production refers to active input by mental health service users in the research process and knowledge production in the context of equal partnerships with academic researchers (Boyle and Harris, 2009; Needham and Carr, 2009; Gillard et al., 2012)

Hard Questions (I) Is genuine co-production (underpinned by equal partnerships) ever attainable in University-based mental health research, if one takes into account the markedly hierarchical, exclusionary and largely non-democratic and non-egalitarian infrastructures, cultures and relations that characterise Academia even when mental health service users/survivors are not in the picture? Hard Questions (II) Or is genuine co-production an ideal to aspire to? Can we talk about co-production in absolute

terms, i.e. something is co-produced or not? Or we can only talk about co-production as a continuum with degrees of co-production? Hard Questions (III) Co-production in University-based research shares similarities with democratic, inclusive, participatory, user-involved, emancipatory research (Nind, 2014) Can University-based research ever be democratic? (Melanie Nind, Democratisation of Research Methods, Talk at ESRC Research Methods Festival, 8-10 July 2014, Oxford, UK; http:// www.ncrm.ac.uk/resources/video/RMF2014/filmed.php?id=9e 04de0

) Hard Questions (IV) Does attempting to democratise research change the nature of research itself? How? How does the democratisation of research change the identities of the people involved? (Melanie Nind, ibid.) When we attempt to democratise research, are we entering a new space (neither academic research nor advocacy)? (Melanie Nind, ibid.) A space that we do not understand yet? (Melanie Nind, ibid.) A new space that is loosely bounded and with more pervious boundaries? (Melanie Nind, ibid.) Paradoxical space

(http://daltarak.blogspot.co.uk) Co-production in Universitybased mental health research as a paradoxical space (Rose, 1993; Spandler, 2009) Potential simultaneously for both emancipation and appropriation/co-optation/as similation (Beresford, 2002) Tensions and contradictions in paradoxical spaces may be creatively explored (Spandler, 2008) and exploited Subversive potential

of paradoxical spaces (Rose, 1993) 8 Service user involvement as appropriation/assimilation/co-optation Editorial - Asylum Toronto [] Many so-called mental health activists have become consumed by assimilationist strategies, opting to promote the idea that change can be delivered from within [the mental health system], and advocating peer support and continuing professional education as the new solution to ageold systemic problems: coercion and forced treatment, racism and white supremacy, poverty, homelessness and social isolation When did we start seeing the mental health care system in the likeness of a group of nave and idiotic professionals doctors, nurses, health practitioners, policy makers who are at the same time well-intentioned and unknowing? And when did we decide that a seat at their table or a moment of their time

would make even a bit of difference? What led us to believe that there was power in disclosing our stories, our experiences and our secrets? When did we start deluding ourselves that we mattered that much or at all, in truth? It would be laughable if it werent so pervasive. And dangerous. (Asylum - The magazine for democratic psychiatry, Volume 20, Number 4, 2013, p.3) )9 Recovering Our Stories: A Small Act of Resistance We all have stories. Many of our stories are deeply personal. Some of our stories are painful, traumatic, hilarious, heroic, bold, banal. Our stories connect usthey reflect who we are and how we relate to one another. Stories are extremely powerful and have the potential to bring us together, to shed light on the injustice committed against us and they lead us to understand that not one of us is alone in this world. But our stories are also a commoditythey help others sell their products, their

programs, their servicesand sometimes they mine our stories for the details that serve their interests bestand in doing so present us as less than whole. - Becky McFarlane, Recovering Our Stories event, June 2011 (Costa et al., 2012, p. 86) 10 Unsettling relations Unsettling relations between academic researchers and mental health service users in processes of co-production in research (Bannerji et al., 1991; Church, 1995; Church 2005) Would you say there are unsettling relations between academic researchers and mental health service users in processes of coproduction in research?

What is the unsettlement about? Mad knowledge as difficult, troublesome and dangerous knowledge Mad knowledge as difficult, troublesome and dangerous knowledge (LeFrancois, Menzies and Reaume, 2013; Pitt and Britzman, 2003; Cooper and Lousada, 2005) Mad knowledge mental health service user/survivor knowledge Knowledge of traumas; knowledge of mental pain; stemming from engagement with distressing, disturbing, threatening, emotionally disruptive experiences Knowledge of unthinkable, unspeakable matters (e.g. madness) Mad (difficult, troublesome and dangerous) knowledge and unsettling relations between academic researchers and mental health service users in processes of co-production in research closely linked?

References Bannerji, H., Carty, L., Dehli, K., Heald, S. & McKenna, K. (1992) Unsettling Relations: The University as a Site of Feminist Struggles, Toronto, Womens Press Beresford, P. (2002) User Involvement in Research and Evaluation: Liberation or Regulation?, Social Policy & Society, 1:2, 95-105 Boyle, D., & Harris, M. (2009) The challenge of co-production, London, New

Economics Foundation Church, K. (1995) Forbidden Narratives: Critical Autobiography as Social Science, London, Routledge Church, K. (2005) Commentary in Tilley, S. (Ed.) Psychiatric and mental health nursing: the field of knowledge, Oxford, Blackwell Science Cooper, A., & Lousada, J. (2005). Borderline welfare: Feeling and fear of feeling in modern welfare, London, Karnac Books Costa, L. et al. (2012) Recovering our stories: A small act of resistance, Studies in Social Justice, Vol 6, Issue 1, 85-101 Gillard, S., Simons, L., Turner, K., Lucock, M., & Edwards, C. (2012) Patient and Public Involvement in the Coproduction of Knowledge: Reflection on the Analysis of Qualitative Data in a Mental Health Study, Qualitative health research, 22(8), 1126-1137 References

Le Francois, B., Menzies, R. and Reaume, G. (eds.) (2013) Mad Matters: A Critical Reader in Canadian Mad Studies, Toronto, Canadian Scholars Press Needham, C., & Carr, S. (2009) SCIE Research Briefing 31: Coproduction: an emerging evidence base for adult social care transformation, Policing, 8(11) Nind, M. (2014) Inclusive research and inclusive education: why connecting them makes sense for teachers and learners democratic development of education, Cambridge Journal of Education, DOI:

10.1080/0305764X.2014.936825 Pitt, A., & Britzman, D. (2003) Speculations on qualities of difficult knowledge in teaching and learning: An experiment in psychoanalytic research, Qualitative Studies in Education, 16(6), 755-776 Rose, G. (1993) Feminism and Geography: The Limits of Geographical Knowledge, Minneapolis, University of Minnesota Press Spandler, H. (2008) THE RADICAL PSYCHIATRIST AS TRICKSTER in Morgan, A. (ed.) Being Human: Reflections on Mental Distress in Society, Ross-on-Wye, PCCS Books Spandler, H. (2009) Spaces of psychiatric contention: A case study of a therapeutic community, Health & Place, 15, 672678 Contact Me! Dr Dina Poursanidou Honorary Research Associate/ Service User Researcher University of Manchester

Centre for Women's Mental Health Institute of Brain, Behaviour and Mental Health Manchester M13 9PL Email: [email protected] nchester.ac.uk Mobile: 0044 (0) 7792358092 15

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