The UK’s public mental health care system is plagued by severe and intractable problems, including understaffing, high workforce turnover, and poor patient outcomes. In response to these challenges, reforms have been proposed — most recently as part the ambitious Community Mental Health Framework — which would decentre care from the hospital and significantly reorient relationships between service users and practitioners. The implications of these shifts for the staff on the frontlines of implementation have not yet been explored.

My project will apply ethnographic methods to understand the implications of high-level policy and organisational change for the experience and well-being of the staff involved. As an embedded researcher, I will follow practitioners within a London mental health trust as they implement the Community Mental Health Framework through the innovative ‘Open Dialogue’ approach. My research will include 16-18 months of participant observation in the mental health Trust, including in-depth interviews with peer-support workers, clinical staff, and NHS administrators.

My study builds on an existing ESRC study of Open Dialogue based at SOAS: the Anthropological study of Peer-supported Open Dialogue (APOD). The distinctive clinical ethnographic method developed by the APOD team is particularly suited to capturing affective and embodied aspects of staff experience and unpacking experiences of marginalisation within a diverse workforce.