Mental health ethnography: doing fieldwork in mental health institutions

In: SAGE Research Methods. Cases. Part 2

Abstract

In 2010, I began a PhD study to examine how professionals and patients talked to, and about, each other in mental health institutions in Denmark. One year later, I found myself chain-smoking, dressed in baggy clothing, and slouching on a sofa in a closed psychiatric ward. I had not myself been hospitalized, but to get inside the contemporary psychiatric institution and to participate in the social world of patients and professionals, I had to experiment with different ethnographic approaches. Ethnographies of mental health have become increasingly rare, and much research on language in psychiatric institutions is done by interview research. My study involved observing and participating in the day-to-day life at two mental health facilities: an outpatient clinic and an inpatient closed ward. The case study provides an account of some of the specific methodological problems and unanticipated events that emerged in the course of the study. It discusses the particular challenges involved in negotiating access in a hierarchical and conflict-ridden setting with tangible power differences between professionals and patients. I pay particular attention to the positions that became available to the researcher during the study, and I discuss different strategies of access. The case also contains some practical advice and lessons learned to consider for new researchers and students looking to do ethnographies in institutional settings.