Title

Understanding moral economics of occupations.

1

Location

Studio 3

Start Time

21-10-2017 11:30 AM

End Time

21-10-2017 12:30 PM

Session Type

Research Paper

Abstract

Title: Understanding moral economics of occupations.

Key words: moral economics, stigma, policies

Purpose: Clubhouses are non-profit settings that support people with serious mental illness (SMI), called members at a clubhouse. In clubhouses, members spend their daytime and work with staff as colleagues to undertake tasks that sustain a clubhouse. While the standards and operating philosophy of clubhouses suggest that members and staff share equitable decision-making agency in operating a clubhouse, the reality depicts a different scenario. Additionally, there is sparse evidence in occupational science regarding stigma within mental healthcare practices and its influence on occupational engagement. Thus, this study aims to identify social processes guiding stigma and occupational engagement for individuals with SMI in clubhouses.

Methods: The doctoral dissertation study began in January 2017 (ending in June 2017) at two clubhouses and is being conducted using ethnography. There are n=41 enrolled participants (n=18 members; n=16 mental healthcare providers). Data collection methods include: interviews, fieldwork/participant observation (over 5months period) at two clubhouses, document review of healthcare documents of service-users, and a survey measure of community participation. Additionally, interviews with n=7 individuals engaged in studying or informing mental health policy were also interviewed to gather further information regarding influence of stigma (within policies) on occupational engagement. Open and axial coding will be used to analyze data (interview transcripts, fieldnotes, and document review). Data from the survey measure will be analyzed using descriptive statistics and statistical findings will be used in conjunction with emergent qualitative patterns.

Preliminary Results: Preliminary findings involve three themes:

  1. Moral economics of occupational engagement involving
    1. Hierarchy of occupations: division of occupations based on one’s position in an institution
    2. Bartering of reason: using reason (division of individuals with mental illness as high or low functioning) to distribute decision-making agency regarding occupational engagement.
  2. Occupations as assets: exchange of occupations to gather social capital, among members and providers.
  3. Institutionalization of discourse: reflection of stigma towards SMI within institutional policies, practices and texts, and its influence on occupations.

Implications for Occupational Science: Occupational engagement is rarely assessed via moral economics that guide human interactions. This study highlights the moral economics, that are informed by the stigma and cultural norms, that guide occupational engagement for individuals with SMI. Further, via document review and interviews with policy makers, this study also provides evidence regarding influence of policies on occupational engagement of service-users and providers in mental healthcare.

Discussion Questions To Further Occupational Science Concepts And Ideas:

  • How is stigma towards mental illness perpetuated via occupational engagement?
  • How is division of occupations maintained or advanced via state or federal policies?
  • What is the utility of ethnography in generating evidence regarding occupational injustices within taken-for granted institutional practices?

References

  1. Angell, A. M. (2014). Occupation-centered analysis of social difference: Contributions to a socially responsive occupational science. Journal of Occupational Science, 21(2), 104-116.
  2. Nyman, A., Josephsson, S., & Isaksson, G. (2014). A narrative of agency enacted within the everyday occupations of an older Swedish woman. Journal of Occupational Science, 21(4), 459-472.
  3. Leufstadius, C., Erlandsson, L. K., Björkman, T., & Eklund, M. (2008). Meaningfulness in daily occupations among individuals with persistent mental illness. Journal of Occupational Science, 15(1), 27-35.
  4. Henderson, C., Noblett, J., Parke, H., Clement, S., Caffrey, A., Gale-Grant, O., ... & Thornicroft, G. (2014). Mental health-related stigma in health care and mental health-care settings. The Lancet Psychiatry, 1(6), 467-482.
  5. Grob, G. N. (1994). Government and mental health policy: A structural analysis. The Milbank Quarterly, 471-500.

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Oct 21st, 11:30 AM Oct 21st, 12:30 PM

Understanding moral economics of occupations.

Studio 3

Title: Understanding moral economics of occupations.

Key words: moral economics, stigma, policies

Purpose: Clubhouses are non-profit settings that support people with serious mental illness (SMI), called members at a clubhouse. In clubhouses, members spend their daytime and work with staff as colleagues to undertake tasks that sustain a clubhouse. While the standards and operating philosophy of clubhouses suggest that members and staff share equitable decision-making agency in operating a clubhouse, the reality depicts a different scenario. Additionally, there is sparse evidence in occupational science regarding stigma within mental healthcare practices and its influence on occupational engagement. Thus, this study aims to identify social processes guiding stigma and occupational engagement for individuals with SMI in clubhouses.

Methods: The doctoral dissertation study began in January 2017 (ending in June 2017) at two clubhouses and is being conducted using ethnography. There are n=41 enrolled participants (n=18 members; n=16 mental healthcare providers). Data collection methods include: interviews, fieldwork/participant observation (over 5months period) at two clubhouses, document review of healthcare documents of service-users, and a survey measure of community participation. Additionally, interviews with n=7 individuals engaged in studying or informing mental health policy were also interviewed to gather further information regarding influence of stigma (within policies) on occupational engagement. Open and axial coding will be used to analyze data (interview transcripts, fieldnotes, and document review). Data from the survey measure will be analyzed using descriptive statistics and statistical findings will be used in conjunction with emergent qualitative patterns.

Preliminary Results: Preliminary findings involve three themes:

  1. Moral economics of occupational engagement involving
    1. Hierarchy of occupations: division of occupations based on one’s position in an institution
    2. Bartering of reason: using reason (division of individuals with mental illness as high or low functioning) to distribute decision-making agency regarding occupational engagement.
  2. Occupations as assets: exchange of occupations to gather social capital, among members and providers.
  3. Institutionalization of discourse: reflection of stigma towards SMI within institutional policies, practices and texts, and its influence on occupations.

Implications for Occupational Science: Occupational engagement is rarely assessed via moral economics that guide human interactions. This study highlights the moral economics, that are informed by the stigma and cultural norms, that guide occupational engagement for individuals with SMI. Further, via document review and interviews with policy makers, this study also provides evidence regarding influence of policies on occupational engagement of service-users and providers in mental healthcare.

Discussion Questions To Further Occupational Science Concepts And Ideas:

  • How is stigma towards mental illness perpetuated via occupational engagement?
  • How is division of occupations maintained or advanced via state or federal policies?
  • What is the utility of ethnography in generating evidence regarding occupational injustices within taken-for granted institutional practices?