in how each participant practised in his/her own individual way, as opposed to broad understandings from the first part of the interview. More importantly, this next part of the interview drew its currency from the answers to the broad questions: the warm up had produced a filter for the participants’ responses and a pool of ideas from the co-construction of the interview for them to continue to define and redefine their responses to this next set of questions.
Important to note again is that mental health promotion was interpreted by over three quarters of the participants as mental illness, hence personal experience sometimes reverted to mental illness experience. In this question, I did continue to endeavour to guide the participants to consider mental health promotion as wellbeing promotion or promotion of the ‘capacity that exists’ (Pollett 2007, p.1). However, the default position came from their broad question responses (as they were describing how they constructed their notions of mental health promotion) and so I felt that to do so more strenuously would be attempting to influence them and be in breach of their chosen positioning. After exploring the participants’ constructions of their practice; finding out the ‘so what’ that could motivate them to discuss or provide mental health promotion, my next
question asked them to describe some examples of mental health promotion at work. Due to my extensive education in communication whilst working as a child health nurse, I had assumed that many, and in particular the child health nurses, would list communication and a trust relationship as important tools or practices for mental health promotion. For all participants, the questions regarding supports and limitations of mental health promotion within the workplace received the most detailed responses within the focussed questions – and in particular limitations to mental health promotion. I had assumed that the issue of ‘inadequate time’ would be raised frequently. However, I was surprised by the number of issues that were discussed as being unsupportive of mental health promotion. The next question was the so called ‘miracle’ question of offering the participant unlimited funds to build mental health promotion in their workplace and in the community. My assumptions were again that although both services claimed to work within a Primary Health Care framework, I was sceptical that connections would be
made to the wider implications of what could be achieved with unlimited funding. Primary Health Care has within its tenets that it is not bound by the silo of health but is intersectoral in nature.
The final question asked the midwives and child health nurses to describe what they thought mental health promotion or emotional wellbeing meant to parents. My assumptions about this question involved a perception of a top-down approach to healthcare delivery in parenting. Midwifery and child health courses are renowned for a framework that emphasises a woman or family centred approach, respectively (AHPRA 2012). Part of this approach demands an engagement of the woman or family in designing their care. However, my lived experience is that the client is more invited into a token engagement only (Arnstein 1969) and that the healthcare system’s structure and delivery are too rigid for two way participation.
In summary, in this section I have considered Madison’s charge “to discuss our positionality as ethnographers and as those who represent Others” (2012 p.7). In discussing my assumptions I have sought to be reflexive and to expose that which Noblit, Flores and Murillo (2004) call a lack of focus on the researcher’s own role in the study. In doing so, I have also aimed to present my questions with analysis as a way of making explicit self-awareness within my positioning, thus, revealing my acts of study in order to lessen what could be interpreted as domination over participants and their responses (Noblit, Flores & Murillo 2004, p.3).
3.7
Conclusion
This chapter has presented the method and methodology utilised in this study of early parenting mental health promotion. The study embraced critical theory as its foundation and a qualitative, critical ethnographic approach as its implementation. The methodologies of interviewing and document analysis were performed to gather the data for this study. The processes of preparation, collection and analysis of these two methodologies were described in this chapter within which ethics considerations such as privacy,
confidentiality, credibility and trustworthiness were discussed. In order to ensure transferability of my findings, I maintained a detailed account of questions,
decide between elements of the study and his/her own experiences (Guba & Lincoln 2005).”This Method chapter ended with a presentation of reflexivity through an
examination of the development of the interview questions.
Introduction to findings/discussion chapters
The following three findings/discussion chapters represent the three overarching themes interpreted from the interviews and document analysis: 1) Complexity of mental health, 2) Default mental illness framework, and 3) Barriers to mental health promotion. Each
chapter begins with an allegory based on my earlier school and university studies (Bachelor of Arts) in English literature and European languages. I do this as a way of understanding and expressing the complex concepts within. Each allegory is representative of the theme each chapter illustrates. Each findings/discussion chapter represents one of the three themes and within each theme are a number of subthemes and concepts.
Each chapter includes an introduction to the theme and then presents the findings through the subsequent subthemes and concepts with supporting quotes from participants
included in italics. Each chapter discusses findings interspersed with discussions from literature that support or refute the themes that emerged in this study of early parenting mental health promotion. The table below provides a visual representation of the themes, subthemes and concepts for purposes of clarity and is included with particular emphasis of shading for each chapter after each introduction.