Discursive contestation in mental health rehabilitation: How Clubhouse support workers expose clients to new interpretative repertoires of work

Abstract

In our society, work is generally considered central to citizenship and individual well-being. However, paid employment is often out of reach for individuals with mental illness. The Clubhouse model is a community-based rehabilitation programme that therefore offers people with mental illness the possibility to enjoy some social advantages of work. However, the status of the day-to-day Clubhouse activities as “work” is a matter of discursive contestation. Drawing on 29 meetings of a Clubhouse rehabilitation group as data, and using conversation analysis and discourse analysis as methods, this study examines two competing interpretive repertoires that are systematically manifested in this context: the capitalist “paid work” repertoire used by Clubhouse clients and the more flexible “productive activity” repertoire used by support workers. The adoption of these two repertoires reflects two competing discursive agendas, which define the scope of mental health rehabilitation and the role of the client in their own rehabilitation process in distinct ways. From this perspective, the support workers' central institutional task is essentially of a discursive and ideological nature—exposing the clients to new ways of talking about their lives with reference to work.