Patients, consumers and survivors: A case study of mental health service user discourses

This paper is an exploratory study of ways of talking about mental health. Drawing upon data collected from mental health service users in the Republic of Ireland, it employs discourse analysis within a case study approach to embellish three 'types' of service user identified in the sociology literature. Rather than being seen as specific types it is proposed that patient, consumer and survivor be regarded as a discursive typology which function as discursive resources for service users. The re-conceptualisation of these types, as discourses, allows the researcher to gain thicker descriptions of the ways in which service users socially construct their own perspectives on mental illness. Through a process of discourse analysis, discourses of patients, consumers and survivors are extrapolated out from interview talk with members of mental health social movement organisations or groups. The identified discourses contain intrinsically different ways of talking about mental illness and allude to different conceptions of agency on the part of the service user. It is argued that they offer an insight into bottom-up social constructions of mental illness. It is proposed that these discourses suggest that notions of patients, consumers and survivors have entered the service users' discursive canon and that they are actively utilised by service users to socially construct their perspectives on mental health. © 2005 Elsevier Ltd. All rights reserved.