139 Perspective matters in recovery R: Because I did not feel confused enough yet to be admitted [...] I was afraid that would happen of course. And my daughter called and asked: where are you? I said: I don’t know exactly. I didn’t want to say where I was, because they would send over the police to pick me up. Which they eventually did. (Not) Informing, or being informed on the position of triad members Informing refers to getting to know the position of the other on an issue, but also to inform others of their own position. Furthermore, they may learn what the other two parties do (not do) with each other, for example, a person with SMI knowing that family and professionals will contact each other in a crisis, or a professional knowing that a person with SMI keeps things secret for his family (see table 3). But misinforming, or not informing may also happen, as illustrated in Box E. Agency to change Having agency (to change) or experiencing others having agency, refers to feeling empowered and/or responsible to act, and to actually take action. Agency could be experienced as shared. Taking agency related to being informed, but also to attributed roles. Especially professionals and family expressed the dilemma over whether to take matters into their hand, which connected to the question whether or not a person with severe mental illness should be viewed incapacitated to decide to a certain extent by illness (Box F). BOX F Psychiatrist who prefers shared agency, e.g. with a person with severe mental illness she treated with lithium. However, she also mentions that she sometimes has to take up the struggle, and decide against the will of a patient, because she felt informed on what would happen otherwise. She also mentions the basis for how she would act: her experience of misalignment on whether or not there is a mental health issue that causes problems R: With [person with severe mental illness], he wants to go off medication. Ok, then we’ll do that. I rather have him find out himself: “when we tapered off that lithium, when I got to this or that dosage, that’s when I got off balance”. Rather than to keep telling him, you have to use your lithium. The most difficult clients, because I really have to be the doctor there, these are the people who really don’t think they are ill at all. And who continue to think so, even though they have been hospitalized for 20 years, and have received compulsory treatment 20 times. And keep blaming the medication. I can take that role, but it’s not my favorite one. Then I say no, you have to get that depot, it is compulsory care. No, we are not going to try tablets another time, because we have already done that eight times and it went wrong eight times. Yes, that’s an awkward position. 7
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