Heterotopias of mental health care: The role of space in experiences of distress, madness and mental health service use.

The change from an institutional to community care model of mental health services can be seen as a fundamental spatial change in the lives of service users (Payne, 1999; Symonds & Kelly, 1998; Wolch & Philo, 2000). It has been argued that little attention has been paid to the experience of the specific sites of mental health care, due to a utopic (idealised and placeless) idea of ‘community’ present in ‘community care’ (Symonds, 1998). This project hence explored the role of space in service users’ experiences, both of mental health care, and community living. Seventeen ‘spatial interviews’ with service users, utilising participatory mapping techniques (Gould & White, 1974; Herlihy & Knapp, 2003; Pain & Francis, 2003), plus seven, already published first person narratives of distress (Hornstein, 2009), were analysed using thematic analysis (Braun & Clarke, 2006). Mental health service sites are argued to have been described as heterotopias (Foucault, 1986a) of a ‘control society’ (Deleuze, 1992), dominated by observation and the administration of risk (Rose, 1998a), which can in turn be seen to make visible (Hetherington, 2011) to service users a passive and stigmatised subject position (Scheff, 1974; 1999). Such visible positioning can be seen to ‘modulate’ (Deleuze, 1992) participants’ experiences in mainstream space. The management of space has hence been argued to be a central issue in the production and management of distress and madness in the community, both in terms of a differential experience of spaces as ‘concordant’ or ‘discordant’ with distress, and with movement through space being described as a key mediator of experiences of distress. It is argued that this consideration of space has profound implications for the ‘social inclusion’ agenda (Spandler, 2007; Wallcraft, 2001).

Feminist Genealogies in the Writing of the Self

Maria Tamboukou links Foucauldian ideas to feminism and education. Its central argument is that the Foucauldian notion of 'technologies of the self' needs to be gendered and contextualized. This argument is pursued through a genealogical analysis of auto/biographical narratives of women educators at the turn of the nineteenth century. This is a new theoretical approach, since Foucault's work has proved to be of great interest to feminist scholars, but as yet, his theroies have only intermittently been used in educational feminist work. The genealogical analysis of situated female sujectivities has highlighted the importance of space in the 'technologies of the female self' and has reconsidered the private/public couplet. It has acted as a continuous source of uncertainty, experimenting with Foucauldian questions of what we are, of how we have become what we are, but also and perhaps most importantly of how we can become other than what we are already.