1: Introduction

The opening chapter provides a rationale for the underlying themes around practice boundaries and introduces the reader to concepts such as framing, frame reflection and policy drama. These ideas have relevance for compulsory mental health work whereby outcomes are understood to be disproportionate, variable and subject to biases. Boundaries are usually subjective, representing rules (formal or informal), safety, or a theoretical, interpersonal, literal or metaphorical divide. There is a need to frame and deconstruct these binary approaches to look at different frames for critical reflection. It goes beyond viewing scenarios in terms of lawful or not lawful; ethical or not ethical; ill or healthy; powerful or powerless; medical or social; us or them; rational or irrational; health or social; mad or bad; self-determination or social control – all ideas that are ubiquitous within psychiatry. The chapter acknowledges boundary work as the different positions competing for authority in mental health. Yet differences that seem insoluble can sometimes be resolved pragmatically by ‘reframing’ the issues and understanding the taken-for-granted assumptions around policy, statements of fact and value judgements. The chapter advances Peattie’s ‘double vision’ – the ability to act from one perspective while being aware of other perspectives.

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