Responsibilization and recovery: shifting responsibilities on the journey through mental health care to social engagement

This paper examines the trajectory of 32 service users through the mental health care system on the path to recovery. It offers a critical appraisal of the processes whereby mental health and social care services attempt to responsibilize the service user in the process of delivering recovery-oriented services. Responsibilization was often found to be onerous and counterproductive and appeared to work against their strivings for autonomy. Acting responsibly was aligned with following instructions from health professionals and managing the demands one made on services. By contrast, participants who described their involvement in civil society organisations described a good deal of effort on their own and other’s behalf, but this was not seen as burdensome, had a sense of being freely chosen and represented a source of satisfaction and accomplishment, scarcely felt as responsibility at all. Meaningful, purposive shared activity was more highly valued and enjoyed. Didactic responsibilization was something imposed on the abject or marginalised individual in the process of engaging with mental health services. However, beyond this, a number of participants had found a more subtle way of acting responsibly through civic engagement in the unmanaged spaces of social life.