1. PRP CONFERENCE 2016: Negotiating power in mental health institutions
How Ontario’s legislation on capacity to consent to treatment is put into practice

2. Topic Decision Sustained interest Personal relevance
Accessible information
Minimal harm

3. Underlying Assumptions of Research
Mental illness exists insofar as it has a tangible impact on the lives affected
The desire for social control plays an important role in how the mental health system is structured
There is a disconnect between legislation on capacity to consent to treatment and how that legislation is enacted
Engaging with institutions involved in the development and application of these laws will help to illustrate the prevailing discourses that underlie the operationalization of this law

4. Further Assumptions
Knowledge is constructed from interactions between people
Mental illness is not a one-size-fits-all experience
People have multiple lived realities which deserve to be taken into consideration in questions of capacity
People who are marginalized experience an “absence of voice” (Kovach, 2005) that is continually reinforced within institutions

5. Literature Review Key Constructs: Mental Illness
Deinstitutionalization
Informed Consent
Capacity & Legal Competence
Coercion

6. Research Design Institutional Ethnography (Dorothy Smith)
“Problematizes social relations at the local site of lived experience” (Walby, 2007);
Explores how texts mediate the everyday practices of institutions;
Explores the potential for collaborative action within unique experiences.

7. Methods Examined texts Conducted interviews
Health Care Consent Act (1996)
Mental Health Act (1990)
Substitute Decisions Act (1992)
Conducted interviews
three ~hour long, semi-structured, open-ended, exploratory
CCB Lawyer, Administrative Lawyer, Patient Relations social worker

8. Findings Themes: Bureaucratic process
Limitations of the health care system
Enactment of legislation
Institutional power
Paternalism

9. Suggestions for current students
Recognize & accept – but continue to address – research limitations
Have a clear picture of what you do (and don’t) want to say
Talk to your classmates & your supervisor – that’s what they’re there for!
Have multiple people read over your paper (I found a mistake very recently…Sorry Anne!)
Remember that revisions ARE necessary and often extremely helpful

10. References
Kovach, M. (2005). Emerging from the margins: Indigenous methodologies. In L. Brown & S. Strega (Eds.), Research as resistance: Critical Indigenous and anti-oppressive approaches (pp ). Canadian Scholars’ Press.
Walby, K. (2007). On the social relations of research: A critical assessment of institutional ethnography. Qualitative Inquiry, 13(7), doi: /