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    Institutional injustice: Implications for system transformation emerging from the mental health recovery narratives of people experiencing marginalisation

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    Author
    Hui, Ada
    Rennick-Egglestone, Stefan
    Franklin, Donna
    Llewellyn-Beardsley, Joy
    Ng, Fiona
    Roe, James
    Yeo, Caroline
    Deakin, Emilia
    Pollock, Kristian
    Slade, Mike
    Keyword
    Psychosis
    Ethnic groups
    Mental health recovery
    Date
    2021
    
    Metadata
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    DOI
    10.1371/journal.pone.0250367
    Publisher's URL
    https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250367
    Abstract
    Background Institutional injustice refers to structures that create disparities in resources, opportunities and representation. Marginalised people experience institutional injustice, inequalities and discrimination through intersecting personal characteristics and social circumstances. This study aimed to investigate sources of institutional injustice and their effects on marginalised people with experience of mental health problems. Methods Semi-structured interviews were conducted with 77 individuals from marginalised groups with experience of mental health problems, including psychosis, Black, Asian and minority ethnic (BAME) populations, complex needs and lived experience as a work requirement. These were analysed inductively enabling sensitising concepts to emerge. Findings Three processes of institutional injustice were identified: not being believed because of social status and personal backgrounds; not being heard where narratives did not align with dominant discourses, and not being acknowledged where aspects of identity were disregarded. Harmful outcomes included disengagement from formal institutions through fear and mistrust, tensions and reduced affiliation with informal institutions when trying to consolidate new ways of being, and damaging impacts on mental health and wellbeing through multiple oppression. Conclusions Institutional injustice perpetuates health inequalities and marginalised status. Master status, arising from dominant discourses and heuristic bias, overshadow the narratives and experiences of marginalised people. Cultural competency has the potential to improve heuristic availability through social understandings of narrative and experience, whilst coproduction and narrative development through approaches such as communities of practice might offer meaningful avenues for authentic expression.
    Citation
    Hui, A., Rennick-Egglestone, S., Franklin, D., Walcott, R., Llewellyn-Beardsley, J., Ng, F., Roe, J., Yeo, C., Deakin, E., Brydges, S., et al. (2021). Institutional injustice: Implications for system transformation emerging from the mental health recovery narratives of people experiencing marginalisation. PLoS ONE, 16(4), pp.e0250367.
    URI
    http://hdl.handle.net/20.500.12904/14738
    Collections
    Mental Health and Behavioural Conditions: General and Other

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