Mental health services
: exploring active and passive approaches to recovery

  • Kathleen Dunham

Student thesis: Master's ThesisMaster of Science by Research


The present study aimed to examine the extent to which mental health service providers’ (SP) intention to empower their service users’ (SU) is realised in their service proposals. The service proposals (i.e. care plans and risk assessments) of three different types of SPs were selected for a critical discourse analysis (CDA) of the interventions proposed and the opportunity they permitted the SU to exercise choice and control based on their level of active/passive engagement with the SU. ‘Active’ approaches conveyed coercive interactions, such as the use of instructions, rules or contracts, thereby restricting SU choice and control, whereas ‘passive’ approaches indicated more hands-off interactions such as guidance or recommendation, thereby permitting or facilitating greater SU choice and control. The materials and SPs consisted of two care plans and one risk assessment from a low security locked rehabilitation hospital (LSLRH), one care plan and risk assessment from a community mental health team (CMHT) and one care plan and two risk assessments from a private rehabilitation SP (RALE). The LSLRH was found to be the most active SP whereas RALE was perceived to be the most passive. The CMHT team was found to be passive, however by contrast to the other documents, it appeared to have less direct contact with SU and largely functioned as a referral agency. The analysis of the data for the LSLRH in particular suggested little may have changed in acute contexts over the last decade since many opportunities for SU choice and control remained limited – an observation also made in previous research in similar contexts (Perkins, 2001; SEU, 2004; Masterson and Owen, 2006; Campbell, 2005: 80-81; Cutcliffe and Happell, 2009; Bentall, 2010; DoH, 2011; Leader 2012). Nevertheless, the results found for RALE offered some optimism in the context of community care. Finally, the present study’s non-invasive approach to evaluating mental health services offered a new method of critically examining service provision and revealing contradictions between rhetoric and reality.
Date of Award2015
Original languageEnglish
Awarding Institution
  • Coventry University


  • Mental Health
  • active and passive
  • recovery

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