Practitioner Narrative Competence in Mental Health Care

This paper aims to develop a model of practitioner narrative competence specifically for mental health care. I begin by considering the status of narratives as a form of evidence. Following Rita Charon and Cheryl Misak, I claim that there is no distinction to be made between evidence-based medicine and narrative medicine. I then explore Charon’s model of practitioner narrative competence, and suggest that it can be fruitfully adapted for mental health care contexts, a project for which I employ Jennifer Radden and John Z. Sadler’s psychiatric ethics. This project brings together two independently promising accounts to develop what I refer to as the adapted model of practitioner narrative competence in mental health care. I argue that this adaptation is necessary because mental health care is a distinct health care setting posing specific challenges. The importance of addressing these challenges can be made clear by considering first-person accounts of those participating in mental health care; here, I give examples in the form of the patient account offered by Michiko Tsukada and the practitioner experience presented by Richard Martinez. I close by considering a possible objection to the adapted model, and suggesting possible ways forward.