‘The Hermeneutic Problem of Psychiatry’ and the Co-Production of Meaning in Psychiatric Healthcare

Abstract

Abstract ‘The co-production of meaning’ is a phrase that has become entrenched in the field of public mental health, adopted almost as a slogan within the literature. But what does it actually mean? Current definitions gesture toward the very broad idea that co-production involves a collaboration between ‘service users’ and healthcare professionals, each contributing their knowledge to better understand and treat mental health problems. Yet, terms such as ‘equal’ ‘reciprocal’, and ‘partnership’ fail to clarify the nature of this ‘co-production’, and how it can be achieved. To better understand the co-production of meaning, we shall attempt to develop an account of co-production through phenomenological psychopathology. Through Hans Georg Gadamer's remarks on ‘the hermeneutic problem of psychiatry’ two key obstacles to ‘co-production’ emerge: 1) contingent problems, and 2) intrinsic problems. In calling attention to these obstacles, we problematise the concept of ‘co-production’ in public mental health, revealing it to be more complex than originally thought. We conclude by arguing that new developments in phenomenological psychopathology can be used to overcome the limitations of ‘co-production’.