The book, the stories, the people: an ongoing dialogic narrative inquiry study combining a practice development project. Part 1: the research context

Uses and Misuses of Recorded Mental Health Lived Experience Narratives in Healthcare and Community Settings: Systematic Review

Mental health lived experience narratives are first-person accounts of people with experience of mental health problems. They have been published in journals, books and online, and used in healthcare interventions and anti-stigma campaigns. There are concerns about their potential misuse. A four-language systematic review was conducted of published literature characterizing uses and misuses of mental health lived experience narratives within healthcare and community settings. 6531 documents in four languages (English, Danish, Swedish, Norwegian) were screened and 78 documents from 11 countries were included. Twenty-seven uses were identified in five categories: political, societal, community, service level and individual. Eleven misuses were found, categorized as relating to the narrative (narratives may be co-opted, narratives may be used against the author, narratives may be used for different purpose than authorial intent, narratives may be reinterpreted by others, narratives may become patient porn, narratives may lack diversity), relating to the narrator (narrator may be subject to unethical editing practises, narrator may be subject to coercion, narrator may be harmed) and relating to the audience (audience may be triggered, audience may misunderstand). Four open questions were identified: does including a researcher's personal mental health narrative reduce the credibility of their research?: should the confidentiality of narrators be protected?; who should profit from narratives?; how reliable are narratives as evidence?).

Triumph and adversity: Exploring the complexities of consumer storytelling in mental health nursing education

Consumer participation in the education of health professionals is increasing, particularly in mental health nursing education and storytelling remains the most frequent approach to consumer involvement. The use of story has tended to be accepted as a legitimate educational tool with limited critique or consideration of its potential consequences presented within the academic literature. A qualitative exploratory research study was undertaken with mental health nurse academics (n = 34) and consumer educators and academics (n = 12), to investigate the perceptions and experiences of mental health nurses and consumers regarding the involvement of consumers in mental health nursing education. Data were analysed thematically. Story was a major theme to emerge from consumer participants and received some attention from nurse academics. Consumers and nurses both referred to the power of story to convey the human experience of mental illness diagnosis and service use; and the vulnerability that can result from storytelling. Consumers also described: story as expectation; preparation and support; and the politics of story. All participants supported the value of storytelling in mental health nursing education. Consumers had considered the complexities in far greater detail. The ongoing value of story as an educational technique requires further research. Equally important is considering a broader range of educational roles for mental health consumers.

Narrative inquiry: A relational research methodology suitable to explore narratives of health and illness

This paper proposes the need for further qualitative research to gain valuable insight into individuals’ experiences of health and illness and the suitability of narrative inquiry as a methodology to investigate these experiences. It is essential to increase qualitative knowledge of individuals’ experiences of illness in order to improve and personalise their care. Narrative inquiry aims to understand knowledge gained from the individual’s narrative of their experiences. Narrative inquiry explores experiences through the dimensions of temporality, sociality and spatiality. The aspect between these dimensions provides an exploratory structure for narratives surrounding health and illness: temporality – when did the illness begin, how will it influence the future; sociality – cultural and personal influences on views of illness; spatiality – surroundings, such as hospitals, and their influence on the health–illness perspective. Narrative inquiry not only provides a deep understanding of the investigated phenomena, it is also provides a rich vibrant narrative presentation of findings for the reader and user of research.

Re-storying narrative identity: a dialogical study of mental health recovery and survival

Some of the complexities of recovery and survival are arguably relatively neglected in current UK mental health nursing policy and, by association, clinical and research practice. In order to redress this, this paper, part of larger research project, will present two short stories, contextualized in a critical theoretical and methodological position. The overall significance of the argument in the paper is in its emerging benefits and implications for users of mental health services, practitioners and researchers. The central, orienting principle in the paper, cohering with all of its strands, is 'narrative re-storying'. Organized in three parts, the first reviews selected relevant background policy and related literature, the contextual and theoretical bases of the paper, and related methodological and ethical issues. The second presents the two stories, and the third brings the paper to a close. It does so in discussing specific and global emerging implications for mental health nursing practice and research, around narrative re-storying as a recovery tool and methodological innovations that include 'hybrid' writing.

Troubling 'lived experience': a post-structural critique of mental health nursing qualitative research assumptions

Qualitative studies in mental health nursing research deploying the 'lived experience' construct are often written on the basis of conventional qualitative inquiry assumptions. These include the presentation of the 'authentic voice' of research participants, related to their 'lived experience' and underpinned by a meta-assumption of the 'metaphysics of presence'. This set of assumptions is critiqued on the basis of contemporary post-structural qualitative scholarship. Implications for mental health nursing qualitative research emerging from this critique are described in relation to illustrative published work, and some benefits and challenges for researchers embracing post-structural sensibilities are outlined.