Self Representation: the Voice of the Service User Movement

The term ‘service user’ is used here to refer to people who use mental health services. (It is also use within the UK’s National Health Service to describe anyone using any service.) Sometimes service users are referred to as one group as if they had one voice, e.g. “service users want this change…”. However, like all groups of individuals, mental health service users are people with some things in common and some differences of opinion. They may form groups because they live in the same area or have had similar experiences (such as the Hearing Voices Network). Some people use mental health services but would not want to connect with, or might not know about, user groups or the service user voice.

Much like anyone who has ever been to see a doctor, the life of a service user cannot be summed up by their written case notes. Case notes are only a partial record of events which are based on other people’s versions and interpretations of the service user experience. They are written by medical practitioners who often take a detached scientific view of each case, focusing on symptoms and treatments and not the individual. Considering doctors’ notes and opinions as the sole resource in the study of mental health care is like judging the history of an entire nation only through government documents.

The effect of relationships with a power imbalance like that described above means that, in both explicit and subtle ways, service users are encouraged to perceive their lives through the eyes and language of those with authority – to see themselves as the sum of their case notes.

Having one’s own version of events heard, valued and recorded can be empowering and emancipating. An oral history archive such as Testimony, is a collection of such stories, told in the person’s own voice, illuminating common experience and revealing the uniqueness of each contributor. It makes us aware that we need to treat people not as types, but as individuals.

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