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Abstracts: Ethics, History and Mental Disorder

Dr Vicky Long (Centre for the History of Medicine, University of Warwick)
Working for Mental Health or for Oneself? The Ethics of Professionalisation for Mental Health Care Workers


During the course of the twentieth-century, many occupational groups have sought recognition as a professional group. Achieving status as a profession was not, however, a straightforward matter and mental health care workers faced a number of ethical dilemmas. In order to gain recognition as a profession they needed to appear altruistic, skilled, and to be working in the interests of the public and their clients. This strategy aimed to counter ideas that the occupation was a trade which operated for profit, and usually led workers to represent mental disorder as an illness requiring skilled medical treatment and sympathetic understanding. However, if the vocational nature of one’s occupation was stressed too much it could create the belief that the job did not require recognition as professional, demanding work, and might lead to the marginalisation of such workers. Efforts to counter these concerns could lead to different representations of mental disorder which placed the interests of patients lower down on the agenda of the worker. Considering the difficulties people diagnosed as mentally ill experienced in gaining access to the media in the early and mid-twentieth century, mental health workers faced the dilemma of deciding whether their interests or those of their patients and clients should be prioritised when they made representations to the public.

Using as case studies the Medico-Psychological Association, the National Asylum Workers’ Union and the Association of Psychiatric Social Workers, this paper will explore the results of different strategies, asking whether professional status could be gained by advancing one’s own interests over those of one’s clients or whether this was perceived as contradicting the professional ethic and thus inhibited an occupation’s claims for professional recognition. The extent to which mental health care workers could advance the interests of mental health service users without achieving widespread recognition and status as a professional status will also be questioned. In short, the paper will explore how the efforts of mental health worker associations to gain status as professions affect the interests of their patients and clients.