1. Objectifs

Intentions :
This «study sought to examine the institutional norms, structures, practices, and corresponding moral experiences around the use of control measures in order to develop care approaches that promote an optimal reconciliation of ethical concerns in child mental health. This was done in partnership with children receiving care in a mental health setting, as well as parents and staff members.» (p. 82)

Questions/Hypothèses :
«This ethnographic study sought to answer the following questions: [What] are the institutional norms, structures, and practices related to conflict/crisis management? [What] are the moral experiences related to conflict/crisis management—both favorable and unfavorable—from the perspectives of children, parents, and staff members? [What] are care approaches that optimally reconcile ethical concerns in child mental health in relation to conflict/crisis management?» (p. 85)

2. Méthode

Échantillon/Matériau :
«The study took place in a mental health day-hospital program for children with behavior challenges located in an urban centre in Quebec, Canada.» (p. 86) «Data collection strategies were operationalized in collaboration with an advisory committee, which included 4 children, 2 parents, and 4 staff members.» (p. 83) The author «performed fieldwork over a 5-month period, from February to June 2016, going in the setting 3 to 5 days every week. Participant observation was the main research strategy […]. [For this part of the research, twelve] children (from 7 to 12 years old) participated on a total of 24 children enrolled in the program. [Then, by using] purposive sampling in collaboration with the advisory committee, key informants were identified to provide insight into the phenomenon of inquiry (7 children; 4 parents; 7 staff members).» (p. 84)

Instruments :
Grille d’observation participative

Type de traitement des données :
Analyse de contenu

3. Résumé

This study «sheds light on important ethical issues related to childhood and mental health. Children are largely viewed as incomplete human becomings, which legitimizes certain institutional norms, structures and practices that situate adults as having a highly authoritative role oriented by a behavioral approach. Within this behavioral approach, children are perceived by the staff as the objects of care and not as agents. Children view themselves as having to comply, conform and acquiesce with the norms, structures and practices in place — as is expected by the staff — which they sometimes agree with and sometimes not, but stated are obliged to do.» (p. 105) Moreover, this study found that children «had highly limited parental support while on the unit. Both children and parents described this as normal, as this is how it would be in their neighborhood schools. Some parents also shared not wanting to intervene with what was happening on the unit, not to send the message to their child that they might disagree with some of the norms or practices in place, which they said could lead to their child being opposed to the program. […] There was a distancing of parents from everyday care, choices and actions, who are the ones legally supposed to make decisions and provide ongoing consent for their child’s care.» (p. 99-100)