Places, spaces and territories: socio-spatial issues on home-based mental health care in France
This post is by Tiago Moreira
The Health and Social Theory group hosted a presentation by Marcos Azevedo, of the Ecoles des hautes Etudes en Sciences Sociales and Centre de Recherche medicine, sciences, sante mentale, societe (CERMES3), on his on-going research on socio-spatial issues on home-based mental health care in France. Entitled ‘Places, Spaces, Territories’, the presentation drew on Marco’s ethnographic fieldwork in three different home-based mental health care services to analyse post-asylum geography in Paris.
Marcos’ point of departure is that home-based mental health care mobilises a spatial vocabulary to embed policy and practice, aiming to address the issues of spatial segregation that are associated with mental distress (isolation, homelessness, wandering, etc.). This raises the questions guiding the study:
how does home-based care affects the experience of time and space for patients and professionals; and how do users manage their time and space, as well as negotiate the management of their living places and spaces within such services.
Focusing on the home visit as an interventional space, Marcos described how professionals render domestic settings as clinically legible and how they invest therapeutic meaning in the collaborative achievement of activities such as ‘cleaning the room’. Seeing these practices as form of territorialisation of the home, Marcos went on to empirically detail how care receivers negotiate their engagement with this process.
Overall, as our Health and Social Theory group learned, Marcos's research provides a rich lens into the transformation of mental health care practices. It opens important questions about the ability of community or home-based mental health care to address the issues of segregation or stigma associated with mental distress. And, in particular, it interrogates the role of spatial concepts and practices in making visible and actionable those issues. For example, under what conditions do such practices enable socio-spatial integration? And, in what circumstances do they lead to reinforcing a mentally distressed person's isolation in the home?
Marcos's continuing analysis will no doubt provide some answers to these questions.