‘Mad, bad and dangerous to know’: the pervasive nature of socio-medical boundaries within mental health day centres

In a research area typically dominated by the biomedical field, this paper seeks to explore the lived experiences of older mental health service users who attend charitable day centres. Traditionally, academic literature has predominantly focussed on a macro-analysis of the social, political and geographical position of those with mental health distress. Subsequently, service users have been positioned as a largely homogenous group who mainly reside on the boundaries of social integration due to the negative social representations of mental health impairment. These postulations can advocate a romanticised notion of how service users engage in consensual and non-judgemental social norms in terms of appropriating the social inclusion of those who experience mental health illnesses. Thus, indicating that a high level of mutual camaraderie exists within this definitive social geography. However, this reductionist approach negates the realities encountered by service users on a daily basis whereby differing medical ascriptions such as ‘depression’ and ‘schizophrenia’ can not only influence a service user’s own self-identity and behaviour but ultimately, the acceptance of other members. Using semi-structured interviews, to date 12 participants aged 50 years and above in the East Midlands area gave their own self-reflections on how their mental health influenced individual use of space. In conclusion, this work indicates that rather than a discrete linear position between the ‘otherness’ of mental health distress and ‘normative’ human geographies, this area remains a complex phenomenon with levels of diversity when linked to diagnostic criteria