Towards Co-Production: An Exploration of the Impact of Technology on Future Citizenship Alongside People with Mental Health Challenges.

Abstract

The central aim of this thesis is to explore how future developments in technology may impact on citizenship for people with mental health challenges. This study examines the following: The key factors that will shape future citizenship; the perceived challenges and opportunities for people with mental health challenges; and the key areas that may contribute to the development of future inclusive citizenship for people with mental health challenges. The purpose is to stimulate discussion and contribute new knowledge to the debate on citizenship in mental health. Future Studies, co-production and community based participatory research methods were used within this study. This was underpinned by a critical realist philosophical position, which provided a framework to critique the use of co- production as a research method (Farr 2018). The research team included an academic researcher (the Doctoral student) and three peer researchers. Participants were from a peer-led mental health organisation (n=10) and a digital technology company (n=4). There were two phases to the research: in the first phase participants from both organisations took part in semi-structured interviews and had the option to join a co-production workshop. The analysis of the interviews and workshops culminated in a film, co-created by the research team. The film, Future Citizenship Broadcast, is a news broadcast set in 2042. In the second phase, the impact of the film was discussed in a focus group with those from a peer-led organisation. All the data was subject to thematic co-analysis (Braun and Clarke 2006; Jennings et al. 2018). Participants identified that the key factors affecting citizenship would be the impact of inequality and division, and the extent to which people had a voice and access to democracy. There were questions raised about the changing nature of what it is to be a human in an increasingly digital world. In addition to the factors above, the citizenship of people with mental health challenges would be particularly impacted in response to whether technology increased connection or led to further fragmentation between people. Their citizenship may also be affected by the extent to which biomedical models of mental illness pervade or whether there is an increased focus on social models, which enable participation. For there to be inclusive citizenship for people with mental health challenges, the rights and opportunities of all citizens need to be enhanced. This requires an increased understanding of intersectionality, lobbying governments and corporations for greater transparency, accountability and inclusion and a revision of mental health legislation. The research also raises questions around the role of mental health services in promoting citizenship and the complexities around how services can both support and suppress citizenship. Participants identified that a key element of promoting inclusion is activism, the importance of people from seldom-heard groups having a voice, and being able to participate in co-production. The research highlights the importance of the role of peer-led mental health organisations in amplifying the voices of people with mental health challenges. In addition, this thesis incorporates a reflective account and critical analysis of the use of co-production as a research method and how it contributes new knowledge to the use of co-production in the context of a PhD.