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Exploring the case for truth and reconciliation in mental health services

Helen Spandler (Department of Social Work, Care and Community, University of Central Lancashire, Preston, UK)
Mick Mckeown (School of Nursing, University of Central Lancashire, Preston, UK)

Mental Health Review Journal

ISSN: 1361-9322

Article publication date: 12 June 2017




The purpose of this paper is to explore the case for a truth and reconciliation (T&R) process in the context of mental health services.


The approach is a conceptual review of T&R approaches; a consideration of why they are important; and how they might be applied in the context of mental health services and psychiatry. First, the paper sets out a case for T&R in psychiatry, giving some recent examples of how this might work in practice. Then it outlines potential objections which complicate any simplistic adoption of T&R in this context.


In the absence of an officially sanctioned T&R process a grassroots reparative initiative in mental health services may be an innovative bottom-up approach to transitional justice. This would bring together service users, survivors and refusers of services, with staff who work/ed in them, to begin the work of healing the hurtful effects of experiences in the system.


This is the first paper in a peer-reviewed journal to explore the case for T&R in mental health services. The authors describe an innovative T&R process as an important transitional step towards accomplishing reparation and justice by acknowledging the breadth and depth of service user and survivor grievances. This may be a precondition for effective alliances between workers and service users/survivors. As a result, new forms of dialogic communication and horizontal democracy might emerge that could sustain future alliances and prefigure the social relations necessary for more humane mental health services.



Spandler, H. and McKeown, M. (2017), "Exploring the case for truth and reconciliation in mental health services", Mental Health Review Journal, Vol. 22 No. 2, pp. 83-94.



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Copyright © 2017, Emerald Publishing Limited

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