Culture, Medicine and Psychiatry

, Volume 30, Issue 1, pp 77–104 | Cite as

WASHING THE CITIZEN: WASHING, CLEANLINESS AND CITIZENSHIP IN MENTAL HEALTH CARE

Article

Abstract

Participation in the community and citizenship for patients are common ideals that inspire improvements in mental health care. But what is meant by citizenship? Here an analysis is made of washing practices in psychiatric nursing in long-term mental health institutions. Four repertoires of washing are described, each oriented towards a specific notion of citizenship. In the first repertoire, washing is part of individual privacy; the patient is “enacted” as an individual whose authenticity should be respected in order to equip him or her for participation in the community. In the second repertoire, washing is a basic skill; the patient must learn to take care of her body in order to become an independent citizen. In the third repertoire washing is a precondition to citizenship; patients are to be helped to develop their potentials so that they can find their way in the community. In the fourth repertoire, washing is one opportunity among others to develop social relations; the extent and quality of these relations define a citizen. This analysis opens up not the question if, but which type of citizenship should be promoted.

Keywords

psychiatry citizenship participation care washing 

Notes

Acknowledgments

Research for this article was supported by N.W.O. (210–11–208). I am grateful to the hospital staff and clients for their cooperation. Many thanks also to the people who have contributed to this article with comments on early drafts: Dorine Bauduin, Marja Depla, Dixi Henriksen, Hans Harbers, Kor Grit, Hans Kroon, Jacomine de Lange, Inge Mans, Ingunn Moser, Jan Pols, Baukje Prins, Estrid Sörensen, Rita Struhkamp, Herma van der Wal, Wubbien Wesselink and Dick Willems. I especially thank Annemarie Mol for discussions on complexities, and for her patience in helping to make this into a readable article. I am grateful to John Law and Vicky Singleton for the philosophical debates on “washing.”

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Department of General Practice, Clinical Methods and Public HealthAmsterdam Medical Center/University of AmsterdamAmsterdamThe Netherlands

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