A Qualitative Study on Individuals’ Understandings of Mental Health Difficulties and How This May Be Shaped by Interactions with Others

  • Jake Small

Student thesis: Master's Thesis


The aim of the study was to explore how individuals make sense of their mental health difficulties and how such understandings can be influenced by people, context, place and culture. Previous research has focused on the causes and prevalence of mental health difficulties and less on how individuals themselves make sense of their difficulties. The limited research available highlights a need to expand knowledge in this area as currently many mental health services users seem to face struggles in making sense of their difficulties and this is likely to be important for recovery. The study draws on Bronfenbrenner’s ecological theory to explore how understandings are shaped by individuals around them and the various social contexts they are a part of. Aims of the study, were to interpret the distal and proximal influences that others have on an individual’s understanding and sense making. This can include microsystem influences such as friends, family, peers, healthcare professionals (the impact of diagnoses and formulation) and charity organisations; Exosystem influences such as the media; Macrosystem influences such as economic background and societal beliefs; and Chronosystem influences such as environmental and historical events. Ten semi-structured interviews were conducted with individuals aged between 18-65 who identified as having struggled with a mental health difficulty for more than 6 months. Participants were recruited from local mental health charities, via social media and snowball sampling. Interview questions focused on how individuals themselves understand and make sense of mental health difficulties, how various social connections influence understanding, the impact of interaction with healthcare service and the role wider society plays in how individuals form understandings. Thematic analysis generated three main themes, eight sub themes and two sub-sub themes. Participants understood their mental health as fluctuating on a spectrum between states of flourishing and languishing where flourishing involves feelings of confidence and resilience and a healthy outlook on life, and languishing includes self-blame and a negative-self-image. There was a sense that they ought to flourish and ought not to languish, and this contributed to a desire to isolation from others. Participants also felt a sense of assumed devaluation within their usual microsystems, due to the impact of internalised stigma from the wider society, though in recent years they had experienced a change in how society positions mental health which led in some cases to normalisation of their difficulties. Additionally, participants suggested that engaging with community organisations could aid understanding and sensemaking, helping to develop the confidence to re-engage with society following a period of feeling isolated. Community organisations facilitated interaction with peers, thus extending their microsystems, which could aid individuals in normalising mental health difficulties.
Date of Award23 Nov 2023
Original languageEnglish
SupervisorDawn Leeming (Main Supervisor) & Alex Bridger (Co-Supervisor)

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