Policy Press

Trusting on the Edge

Managing Uncertainty and Vulnerability in the Midst of Serious Mental Health Problems

By Patrick Brown and Michael Calnan


Apr 18, 2012

Page count

144 pages




240 x 172 mm


Policy Press
Trusting on the Edge

Trust is fundamental to everyday interactions and the functioning of society. How trust develops, or fails to develop, within contexts of severe mental illness is a pertinent topic for social scientists and healthcare professionals, not simply because it is an under-researched area but because heightened uncertainty and amplified vulnerability amidst psychosis represent a crucible of the conditions where trust becomes relevant.

Grounded in research within this crucible, this book explores a number of questions which are central to contemporary theoretical debates around the nature of trust. The authors link these abstract concerns to empirical analysis, involving interviews with service-users, practitioners and managers. This book will appeal to anyone interested in the concept of trust, including social science researchers and students, as well as practitioners, managers and policy makers working with vulnerable people.

"An important analysis of trust in relation to mental health care, showing clearly how an instrumentalised focus on 'risk' is in crucial respects antithetical to a personal focus required to build trust; and that how well trust is established at one level in an organisation strongly influences its development at others." George Szmukler, Institute of Psychiatry, King's College London

"The issue of trust is at the heart of contemporary health care. This timely study focuses on how trust functions in the mental health arena where service users and those delegated to care for them have to deal with uncertainty and vulnerability on a daily basis. It provides some fascinating insights into the salience of trust in this context and makes an important theoretical contribution to the literature. The implications for policy and practice are also clearly stated." Jonathan Gabe, Royal Holloway, University of London

Patrick Brown is an Assistant Professor in Sociology at the University of Amsterdam. He has published widely on trust, the governance of risk, and connections between these two processes.

Michael Calnan is Professor of Medical Sociology at the University of Kent. He has worked in health policy and health services research and training for over 20 years, with his current research interests including diffusion and innovation in health care and technology, trust and health care, dignity and the provision of health and social care for older people.

Introduction: Risk and trust in late-modern society; Investigating trust: some theoretical and methodological underpinnings; Constructing knowledge through social interactions: the role of interpersonal trust in negotiating negative institutional conceptions; Bridging uncertainty by constructing trust: the rationality of irrational approaches; Vulnerability and the 'will to trust'; The difficulties of trust-work within a paradigm of risk; Trusting on the edge: Iimplications for policy.