The governance of sexuality in a Recovery-oriented mental health service: Psychosis, consumers and clinical approaches

Journal article


Evans, Alicia M., Quinn, Chris and McKenna, Brian. (2020) The governance of sexuality in a Recovery-oriented mental health service: Psychosis, consumers and clinical approaches. Journal of Psychiatric and Mental Health Nursing. 27(2), pp. 194 - 202. https://doi.org/10.1111/jpm.12569
AuthorsEvans, Alicia M., Quinn, Chris and McKenna, Brian
Abstract

Introduction The Recovery approach introduced a radical shift in the positioning of consumers as subjects rather than objects of mental health treatment. While this approach has been internationally adopted, the practice of Recovery has been under‐researched and a knowledge gap exists regarding the intersection of sexuality and psychosis. Aim The study aim was to investigate how sexuality was governed in a long‐stay mental health rehabilitation facility that was Recovery‐oriented. Method A case study methodology with a conceptual framework using Foucault's work on disciplinary power was used. Results The findings illustrated how mental health clinicians were caught between two main and incompatible models of care: a psychiatric one and a Recovery one. Discussion While the policy framework authorized a Recovery approach, clinicians practised surveillance, hierarchical observation and normalization, which are tenants of a psychiatric model of care. However, the study found that sexuality was an area that opened questions about the psychiatric model for clinicians. Consideration of consumers' sexual needs allowed the clinicians to think of consumers more as subjects like themselves than as objects to be treated. Implications for practice Consideration of consumers' sexuality opens up possibilities for questioning the objectification of the consumer via the psychiatric model.

KeywordsFoucault; governance; mental health; psychosis; recovery; sexuality
Year2020
JournalJournal of Psychiatric and Mental Health Nursing
Journal citation27 (2), pp. 194 - 202
PublisherWiley-Blackwell Publishing Ltd.
ISSN1351-0126
Digital Object Identifier (DOI)https://doi.org/10.1111/jpm.12569
Scopus EID2-s2.0-85074813495
Page range194 - 202
Research GroupSchool of Nursing, Midwifery and Paramedicine
Place of publicationUnited Kingdom
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Diesfeld, Kate and McKenna, Brian. (2006) The therapeutic intent of the New Zealand Mental Health Review Tribunal. Psychiatry Psychology and Law. 13(1), pp. 100 - 109. https://doi.org/10.1375/pplt.13.1.100
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McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2006) Best practice management strategies for mental health nurses during the clinical application of civil commitment: an overview. Contemporary Nurse. 21(1), pp. 62 - 70. https://doi.org/10.5172/conu.2006.21.1.62
Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992
McKenna, Brian, O'Brien, Anthony John, Dal Din, Toni and Thom, Kate. (2006) Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992. International Journal of Mental Health Nursing. 15(2), pp. 128 - 134. https://doi.org/10.1111/j.1447-0349.2006.00412.x
The role of mental illness in homicide-suicide in New Zealand, 1991 - 2000
Moskowitz, Andrew K., Simpson, A., McKenna, Brian, Skipworth, Jeremy J. and Barry-Walsh, Justin B.. (2006) The role of mental illness in homicide-suicide in New Zealand, 1991 - 2000. Journal of Forensic Psychiatry and Psychology. 17(3), pp. 417 - 430. https://doi.org/10.1080/14789940600761410
Outpatient commitment and coercion in New Zealand: A matched comparison study
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2006) Outpatient commitment and coercion in New Zealand: A matched comparison study. International Journal of Law and Psychiatry. 29(2), pp. 145 - 158. https://doi.org/10.1016/j.ijlp.2004.07.004
Gambling and problem gambling among recently sentenced women in New Zealand prisons
Abbott, Max W. and McKenna, Brian. (2005) Gambling and problem gambling among recently sentenced women in New Zealand prisons. Journal of Gambling Studies. 21(4), pp. 559 - 581. https://doi.org/10.1007/s10899-005-5563-5
Patient or consumer? The colonization of the psychiatric clinic
Evans, Alicia. (2005) Patient or consumer? The colonization of the psychiatric clinic. International Journal of Mental Health Nursing. 14(4), pp. 285 - 289. https://doi.org/10.1111/j.1440-0979.2005.00395.x
Gambling and problem gambling among recently sentenced male prisoners in four New Zealand prisons
Abbott, Max W., McKenna, Brian and Giles, Lynne C.. (2005) Gambling and problem gambling among recently sentenced male prisoners in four New Zealand prisons. Journal of Gambling Studies. 21(4), pp. 537 - 558. https://doi.org/10.1007/s10899-005-5562-6
New nurses face endemic violence
McKenna, Brian, Poole, Suzette J., Smith, Naumai A. and Cloverdale, John H.. (2004) New nurses face endemic violence. Kai Tiaki: Nursing New Zealand. 10(5), pp. 12 - 14.
Homicide and mental illness in New Zealand, 1970-2000
Simpson, A., McKenna, Brian, Moskowitz, Andrew K., Skipworth, Jeremy J., Barry-Walsh, Justin B. and Simpson, Sandy. (2004) Homicide and mental illness in New Zealand, 1970-2000. British Journal of Psychiatry. 185(NOV), pp. 394 - 398. https://doi.org/10.1192/bjp.185.5.394
Patients' perceptions of coercion on admission to forensic psychiatric hospital: A comparison study
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2003) Patients' perceptions of coercion on admission to forensic psychiatric hospital: A comparison study. International Journal of Law and Psychiatry. 26(4), pp. 355 - 372. https://doi.org/10.1016/S0160-2527(03)00046-3
Horizontal violence: Experiences of Registered Nurses in their first year of practice
McKenna, Brian, Smith, Naumai A., Poole, Suzette J. and Cloverdale, John H.. (2003) Horizontal violence: Experiences of Registered Nurses in their first year of practice. Journal of Advanced Nursing. 42(1), pp. 90 - 96. https://doi.org/10.1046/j.1365-2648.2003.02583.x
Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation
Farrow, Tony L., McKenna, Brian and O'Brien, Anthony John. (2002) Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation. International Journal of Mental Health Nursing. 11(3), pp. 164 - 169.
Initiating committal proceedings 'just in case' with voluntary patients: a critique of nursing practice
Farrow, Tony L., McKenna, Brian and O'Brien, Anthony John. (2002) Initiating committal proceedings 'just in case' with voluntary patients: a critique of nursing practice. Nursing Praxis in New Zealand. 18(2), pp. 15 - 23.
Risk assessment of violence to others: time for action
McKenna, Brian. (2002) Risk assessment of violence to others: time for action. Nursing Praxis in New Zealand. 18(1), pp. 36 - 43.
An analysis of procedural justice during psychiatric hospital admission
McKenna, Brian, Simpson, A., Cloverdale, John H. and Laidlaw, Tannis M.. (2001) An analysis of procedural justice during psychiatric hospital admission. International Journal of Law and Psychiatry. 24(6), pp. 573 - 581. https://doi.org/10.1016/S0160-2527(00)00069-8
Debating forensic mental health nursing
McKenna, Brian and Poole, Suzette J.. (2001) Debating forensic mental health nursing. Kai Tiaki: Nursing New Zealand. 7(6), pp. 18 - 20.
What is the role of procedural justice in civil commitment?
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2000) What is the role of procedural justice in civil commitment? Australian and New Zealand Journal of Psychiatry. 34(4), pp. 671 - 676. https://doi.org/10.1046/j.1440-1614.2000.00744.x
Implications for training of violent acts by patients against psychiatry registrars
Gale, Christopher K., Simpson, A., McKenna, Brian and Cloverdale, John H.. (2000) Implications for training of violent acts by patients against psychiatry registrars. Australasian Psychiatry. 8(4), pp. 345 - 348. https://doi.org/10.1046/j.1440-1665.2000.00289.x
Patient perception of coercion on admission to acute psychiatric services: The New Zealand experience
McKenna, Brian, Simpson, A. and Laidlaw, Tannis M.. (1999) Patient perception of coercion on admission to acute psychiatric services: The New Zealand experience. International Journal of Law and Psychiatry. 22(2), pp. 143 - 153. https://doi.org/10.1016/S0160-2527(98)00039-9
To tell or not to tell?
McKenna, Brian. (1997) To tell or not to tell? Kai Tiaki: Nursing New Zealand. 3(4), pp. 28 - 29.