The application of rigour in ethnographic methods to achieve an in-depth exploration of care planning with people on treatment orders

Abstract

Community treatment orders (CTOs) remain contested in their efficacy and rationale for use in mental health care. Regardless of the debate, consumers, carers and clinicians are frequently required to engage within this context of forced care. CTO legislation states that treatment and care should be recovery-focussed, though care is often coercive. Positive gains for individuals come at a cost. This study seeks to understand the interpersonal and broader systems issues that impact on the care planning process. Carspeckena's Critical Ethnography, combining critical social theory with ethnographic methods, provided a rigorous theoretically-based structure for data collection and analysis. Ethnographic methods (including observation, focus groups and interviews) provided a detailed account of the multi-perspectives of people on CTOs, their families, and treating clinicians, over an 18-month period in a community mental health team in Adelaide, Australia. This paper will explore the research process of conducting an ethnographic study within the researchers' own work setting. Data collection and first stage analysis occurred concurrently, with coding of early observations informing the next stage of data collection, individual interviews. Concepts central to the rigour of an ethnographic study (immersion in the field, researcher positioning, and reflexivity) will be discussed, with illustrations of both successes and challenges.