Trapped in contradictions: professionals’ accounts of the concept of schizophrenia and its use in clinical practice

Abstract

ABSTRACT Background The concept of schizophrenia has been contested since its inception. Over the last decades, criticism of the concept has become increasingly mainstream and calls for its abandonment have intensified. Nevertheless, the concept remains widely used and retains taken-for-granted status within much mental health research and practice. The combination of its contested status and continued use raises questions about how it is used and with what implications for people who receive the diagnosis. Methods This study explores how ‘schizophrenia’ is spoken about by mental health professionals who use the diagnosis in day-to-day practice. Eight interviews with professionals across professions were analysed using Foucauldian Discourse Analysis. Results Two striking and consistent themes were identified. The first is a discrepancy between the way participants talked about ‘schizophrenia’ to the interviewer, and the way they described talking about it in clinical encounters. The second is the potentially entrapping impact of the wider discourses participants drew on in talk about clinical encounters. Conclusions The study concludes with reflections on how those working in the mental health field can break out of this discursive entrapment, and help the people they work with do the same.